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Services for Students with Disabilities
SSD Coordinator Form
This form will establish you as the SSD Coordinator for your school and allow you to obtain access to SSD Online. If you do not already
have a professional login account with the College Board, you will need to create one at https://account.collegeboard.org/login/login. If
you are the SSD Coordinator for more than one school, you will need to submit a separate form for each school you work with, but you
should create only one professional login account.
Each school’s primary SSD Coordinator will also be considered the school’s Testing Coordinator for in-school College Board testing. If a
school administers in-school tests, the primary SSD Coordinator will be responsible for receiving secure tests, as well as generating testing
rosters and Nonstandard Administration Reports for school-based testing.
Complete, sign, and fax this form to the College Board’s Services for Students with Disabilities at 866-360-0114. Do not attach a cover
sheet to this form when faxing. All fields are required.
School Information
If your school doesn’t have a code, enter “N/A” in the school code field and you will be sent a form to request one. If you don’t know your
school’s code, look it up at http://sat.collegeboard.org/register/sat-code-search.
School Code: __________ School Name: __________________________________________________________
School Address: ______________________________________________________________________________
City: ____________________________________________ State: __________________ ZIP Code: __________
Country: ____________________________________________________
Coordinator Information
Last Name: ___________________________________ First Name: __________________ Middle Initial: ______
Gender:
Male ~ Female Another
Work Telephone: _____________________Email: ___________________________________________________
Forms without valid, school-issued email addresses cannot be processed; please ensure your email is correct before submitting.
Are you the primary SSD Coordinator for your school? Yes No
If not, provide the name of your school’s primary SSD Coordinator: ____________________________________
Signatures
I confirm that I am my school’s authorized Services for Students with Disabilities Coordinator, or authorized to serve in this capacity, and
assume the responsibilities that include: advising staff and students of proper procedures in applying for testing accommodations;
submit accommodation requests on behalf of students; and maintain documentation related to students’ accommodations and
disabilities. If I serve as the SSD Testing Coordinator, I also assume responsibility for providing secure testing conditions and timely return
of materials.
SSD Coordinator Signature: ______________________________________________ Date:
Principal: Please be aware that by signing this form, you are permitting this individual to request accommodations for College Board
tests, and to access students' personal disability information.
School Principal or Assistant Principal Name: _______________________________________________________
School Principal or Assistant Principal Signature: __________________________________ Date:
School Principal or Assistant Principal Email: _______________________________________________________
