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Online Student Application

Two easy steps to register
Please notify Disability Resources and Services (DRS) if you require assistance completing the Student Application. All information obtained by DRS will be maintained in accordance with applicable confidentiality standards.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 7 alpha numeric characters.
  4. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
Additional Information
  1. Secondary Disability(ies)

    ADHD

    Autism Spectrum Disorder

    Chronic/Systemic

    Deaf/Hard of Hearing

    General Category

    Learning Disability

    Orthopedic

    Psychological

    Traumatic Brain Injury

    Visual

  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)

Questions

  1.  
    Please select the following major life activities that you believe your disability impacts. * (Selection is Required)
  2.  
    Which type of accommodation(s) are you requesting? Check all that apply. * (Selection is Required)

Please use the following function if you need more than 15 minutes to complete the application. A maximum of 60 minutes before the session is removed.

Session Extender

Status: off
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