Assistive Technologist-Appointment Request:

First Name: *

Last Name: *

Student Identification Number:

St. Clair College Email Address: *

Phone: *

Program: *

Campus: *

Windsor Campus - South Windsor Campus

St. Clair Centre for the Arts - SCCA Downtown Campus

Chatham Campus

Specific Area of Concern/Wish to Discuss: (select most appropriate topic) *