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Online Student Application

Two easy steps to register
Welcome to Disability Support Services at Western Nevada College. We look forward to meeting you to discuss your accommodation needs.

Disability Support Services offers a wide range of support services and accommodations for all students with disabilities. Appropriate services are determined and provided based upon the impact of the student's disability and the academic requirements of the appropriate department or program.

By submitting this form, I acknowledge that: (1) only I, the student or applicant, have filled out this form; (2) this application will not be processed until pertinent documentation of disability has also been provided; (3) the Disability Support Services office staff will consider the accommodations as requested on this form; (4) I authorize the Disability Support Services staff to consult as part of the review process; (5) accommodations, if rendered, may not be the same as those I received in high school or at another institution, and will not apply retroactively; (6) the accommodation determination process may take up to 14 days.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter your NSHE ID without W.
  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.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Affiliation(s)
  2. Ethnicity(ies)
  3. Campus Location(s)
Questions
  1.  
    What are your reasons for coming to see us? (Please check all that apply)
  2.  
    Which accommodation(s) are you requesting access to? While this list is not comprehensive, it provides us with an overview of the accommodations you are requesting. More detail will be discussed during our intake meeting.
  3.  
    Do any of the following apply for your credit requirements?
  4.  
    How many times do you read something for comprehension? * (Selection is Required)
  5.  
    Outside of Lecture, how much time do you devote to studying in an average week? * (Selection is Required)
  6.  
    Do you have difficulties with attention or concentration during lectures? * (Selection is Required)
  7.  
    Have you ever received any special education services (e.g. IEP/504 plan, resource room, speech therapy). * (Selection is Required)
  8.  
    Are you currently, or have you previously been prescribed any medications related to your disability? If yes, please list any relevant medications. * (Selection is Required)
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