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Online Student Application

Two easy steps to register
If you are interested in receiving reasonable accommodations based on a disability, please answer the questions below to the best of your ability. Once completed, you will have an opportunity to upload any documentation on the next page.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 9 numeric characters (ex. 900012345)
  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.
  2. Hint: Enter 10-digit number only.
Additional Information
  1. Secondary Disability(ies)

    Attention Deficit/Hyperactivity Disorder (ADHD)

    Brain Injury

    Communication Disability

    Deaf and Hard of Hearing

    Learning Disability

    Mobility Disability


    Psychological Disabilities


  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)
  1. Are you a first semester undergraduate student? *
  2. Are you requesting accommodations for on-campus housing? *
  3. Please select how you identify with the following statement: I am independent in managing my disability related needs. *
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