Guttman LEADS Interest Form

Thank you for your intrest in our LEADS Program at Guttman Community College. LEADS (Linking Employment, Academics Disability Services) is a unique program designed to prepare our students  to make realistic academic and career choices and develop the skills that will result in successful career outcomes. In order to provide you with LEADS services, please submit our application. Once we recieve your instrest form a LEADS Specialist will reach out to you to discuss your academic and professional needs. 

Phone #:
Guttman Empl ID:
Guttman E-mail:
Personal Email:
Employment Goal: (Check all that apply)
Are you currently working?
Do you have a current resume?
Are you currently registered with the Office of AccessABILITY Services?
Currently open case with ACCES-VR?
If yes, ACCES-VR Counselor, Please provide the contact information:
Are you currently working with other agencies/organizations that provides academic support services?
What is your current program of study you intend to pursue at Guttman?
Which LEADS Services are you interested in receiving? (Please check off all that apply)

RELEASE STATEMENT: I authorize the exchange of information between CUNY LEADS, Guttman Advisor, Staff and Faculty, ACCES-VR and Employers on my behalf.