Skip to Main Content Skip to Tabs Skip to Sub-Tab Navigation

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.
  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.
  2. Hint: Enter 10-digit number only.
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)

    ADHD

    Autism Spectrum Disorder

    Chronic Medical Condition

    General Category

    Hearing Impairment / Deaf

    Learning Disability

    Mental Health

    Neurological

    Physical

    Visual Impairment / Blind

  2. Affiliation(s)
  3. Ethnicity(ies)
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.
Licensed to Accessible Information Management LLC Copyright © 2010-2020 by Haris Gunadi. All rights reserved.