Application to the Access Program

You may submit this application online or print it out and mail it to:

Access
Community College of Rhode Island
400 East Avenue
Warwick, RI 02886

Before starting the application, please note: you must have applied to the College and be enrolled in a degree or transfer program to be considered for the Access program. For more details on our program requirements, please see the Eligibility page.

All fields must be completed for the application to be processed.

Date:

First Name:

Middle Initial:

Last Name:

Street Address:

City:

State:

Zip/Postal Code:

Date of Birth:

8-Digit CCRI ID#*:

Home Phone: (xxx-xxx-xxxx):

Cell Phone: (xxx-xxx-xxxx):

E-mail:

Primary Campus:

Referred By:

Degree Program:

*Your CCRI ID# is the 8-digit number below your name on your Student ID. The number is also visible within MyCCRI. After logging-in, select: "For Students > Student Schedule". Your ID# will appear on the right-hand part of the "Select Term" screen, to the left of your name.

Access Eligibility. Please select all that apply. You must select at least one to qualify for Access. If you have questions about the meaning of these terms, please see the Eligibility page.

Low Income:

yes no

First-Generation Student:

yes no

Documented Disability:

yes no