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Online Student Application

Two easy steps to register
In order to receive academic accommodations for your disability. Please answer the questions below. In addition you will need to submit documentation from the appropriate professional. Please see the Disabilities Resources Policy manual on our website for details on the information that will need to be included in this documentation. http://www.scu.edu/studentlife/disabilities/
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Please use your student ID number, removing the W and adding as many zeroes as needed in the front to make it 11 digits. For example, if your student ID is W0123456, you would enter 00000123456.
  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 (i.e. enter 5417377000 for 541 737 7000).
Local Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Secondary Disability(ies)

    General Category

  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)
Please indicate here any services you might have received in high school or another institution of higher education. Please indicate all that you were granted, even if you did not use them.

Prior Accommodations

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing
Others
Notetaking Services
Classroom Access
Housing
In Class Accommodations
Please indicate here the services that you are requesting at Santa Clara University. At the end of the application you will be asked to explain briefly how these will support your disability.

Any requested accommodations MUST be listed as recommendations in the documentation you submit.

Requesting Accommodations at DR

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing
Others
Notetaking Services
Classroom Access
Housing
In Class Accommodations
Questions
  1. Please indicate your class for the INTITIAL term you are requesting accommdations. If you are a transfer student, please mark Transfer Student and the class you are entering in.
  2. Do you have any medical conditions that may cause you to miss class?
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