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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.
  7. Hint: Enter 9 numeric characters (ex. 900012345)
  8. 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
  2. Secondary Disability(ies)

    Attention Deficit/Hyperactivity Disorder (ADHD)

    Brain Injury

    Communication Disability

    Deaf and Hard of Hearing

    Learning Disability

    Mobility Disability

    Other

    Psychological Disabilities

    Vision

  5. Affiliation(s)
  6. Ethnicity(ies)
  7. Campus Location(s)

Questions

  1.  
    Are you a first semester undergraduate student? * (Selection is Required)
  3.  
    Are you requesting accommodations for on-campus housing? * (Selection is Required)
  7.  
    Please select how you identify with the following statement: I am independent in managing my disability related needs. * (Selection is Required)
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