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Online Student Application

Two easy steps to register
This application is for students that do not have disability accommodations at Bellevue College, and would like to discuss them. Check out our Getting Started with the DRC page for more information about our accommodations process or contact us!

Email Confirmation: When this form is submitted successfully you will receive an email confirmation at your Bellevue College email address. If you do not receive a confirmation email, please email us to let us know!
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. NOTE: Please enter the first name you most commonly use, would like to appear on all correspondence from the DRC, and/or want to be referred to as.
  4. Hint: Enter nine (9) numeric characters. This can be your Bellevue College SID number or your ctcLink ID number. If you have questions, please contact us.
  5. 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.
  3. Hint: Please enter your Bellevue College email address (@bellevuecollege.edu)
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)
Questions
  1. Can we leave detailed voicemails?
  2. Do you need an interpreter? ¿Necesita un intérprete?
  3. If you are not registered to vote where you live now, would you like to register to vote now? *
  4. Identity-based questions are asked because we believe that students with disabilities are an integral part of diversity. This information is confidential and will only be used in anonymous data analysis. Let us know if you have any questions!
  5. Optional Information: Sexual and Romantic Orientation
  6. Optional Information: Have you served in the military?
  7. Optional Information: Religion/Spirituality
  8. Optional Information: My annual income is...
  9. Is there anything else you want the DRC to know?
  10. A successful submission of this form will send an automatic email to your Bellevue College (BC) Email address. Please be sure to check your email regarding next steps. *
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