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Online Student Application

Two easy steps to register
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 7 alpha numeric characters.
  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.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Secondary Disability(ies)

    ADHD

    Autism Spectrum Disorder

    Chronic Medical Condition

    General Category

    Hearing Impairment / Deaf

    Learning Disability

    Mental Health

    Neurological

    Physical

    Visual Impairment / Blind

  6. Affiliation(s)
  7. Ethnicity(ies)

Prior Accommodations

Alternative Testing
Other

Requesting Accommodations at ASC

Alternative Testing
Other

Questions

State Law Notice

State law requires that you be informed of the following:

  • With few exceptions, you are entitled on request to be informed about the information the University collects about you by use of this form.
  • Under sections 552.021 and 552.023 of the Government Code, you are entitled to receive and review the information.
  • Under section 559.004 of the Government Code, you are entitled to have the University correct information about you that is incorrect.
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