DRAFT 2026 CCS Questionnaire Posted on January 12, 2026 | by Patti Parker DRAFT 2026 CCS Questionnaire Personal Information SectionName *Preferred Name (if different than full name)Date of BirthGenderFemaleMaleWrite inPhoneEmail Address *Street AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweStudent HistoryDocumented DisabilityDocumented disability as defined by the Code of Federal Regulations.Do you have a documented intellectual disability?YesNoNot sureDocumentation of DisabilityPlease be aware that documentation of a intellectual disability as defined by the Higher Education Opportunity Act, 2008 is required for consideration of admission to the College and Career Studies program.Will you be able to provide documentation of an intellectual disability? Individual Education Program (IEP), psychological evaluation, etc.YesNoMaybeContact 1Contact 2Please list any high schools you have attendedWhen did (do you expect to) finish high school? (month and year)Did you (or do you plan to) exit high school with:Standard High School DiplomaAlternative High School DiplomaNo diplomaNot sureWhat activities (sports, clubs, teams, social activities) have you participated in during high school? (These could be school-based or in the community.)Program InformationWhat are some reasons why you want to attend college?What are some subjects that interest you?Is there anything else you would like to tell us about yourself?Is there a legal order in place for someone else to make decisions on your behalf in certain situations, such as a legal guardianship or power of attorney?No, I am my own guardian and have no legal orders in place of this kindI am my own guardian, but I do have a power of attorney in place in case of an emergencyI have a legal guardian other than myself who helps make decisions on my behalfWho is person?How did you hear about the College and Career Studies program?High School TranscriptChoose FileNo file chosenDelete uploaded fileLetter(s) of RecommendationThis can be from anyone who knows you and can explain why they believe this program would be a good fit for you. Potential sources: teachers, principal, IEP team members, employment specialist, family or community contact. You may upload multiple files. If you do not have a letter of recommendation, please email one to erin.fitzgerald@uky.edu within two weeks of submitting the application.Drag and Drop (or) Choose FilesDocumentation of Intellectual DisabilityTo see the definition of an intellectual disability, please refer to this guide.Drag and Drop (or) Choose FilesSubmitSave as DraftPlease do not fill in this field.