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

Online Student Application

Two easy steps to register
This form is intended for students or prospective students who are interested in requesting access services from SOU or would like to self-identify as a person with a disability.

We ask that the student, rather than a parent or other interested party, be the one who fill out this application. While we are enthusiastic supporters of families and advocates working to support our students, students themselves must be at the absolute center of what we do. Students and prospective students, we encourage you to talk about the questions on this application with your family and advocates, as appropriate.

If you need accommodations, Disability Resources uses this as one piece of information to help us determine what accommodations you will have available to you here at SOU. Other critical pieces of information are our conversation with you during your appointment(s) and your disability documentation. Please complete this form and submit it along with documentation of your disability. You may find information about documentation at https://inside.sou.edu/dr/qualify.html#documentation-requirements.

Timing of requests
While requests for accommodations may be made at any time, we strongly encourage you to submit this request with your disability documentation as early as possible. Doing so will help us to provide accommodations in a timely, accurate, and efficient manner.

Accessible housing requests (including Assistance Animal requests) may be submitted at any time and SOU will make a good faith effort to accommodate. Because housing availability is limited, SOU may not be able to accommodate requests that are made after the following:
  • 45 days before the start of any term for Assistance Animal requests;
  • August 1 for fall term;
  • December 1 for winter term; and
  • March 1 for spring term.


Students who are approved for accessible housing requests after these dates may be placed on a wait list.

Privacy
Information provided to Disability Resources is confidential. DR staff may consult with subject matter experts in various fields regarding accommodation requests; your FERPA rights in that process are protected and no personally identifiable information will be released outside of SOU without your written permission. Please note: Information disclosed to SOU's Student Health and Wellness Center on the Health History Form is not shared with Disability Resources.

If you have questions about this form, please contact us at (541)552-6213, ext. 2, or by email at dr@sou.edu

Responses are required for all questions. Please use "Not Applicable" if the question does not apply to your situation.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 9 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)

    General Category

  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)

Prior Accommodations

Housing Accommodations
Emergency response/Evacuation support service

Requesting Accommodations at DR

Housing Accommodations
Emergency response/Evacuation support service

Questions

  1.  
    What is your student status? * (Selection is Required)
  2.  
    What is your degree program? * (Selection is Required)
  3.  
    Are you requesting services from Disability Resources? * (Selection is Required)
  4.  
    In your own words, please describe your disability and its impact on your daily life. * (Selection is Required)
  5.  
    How does your disability impact you in an academic setting? * (Selection is Required)
  6.  
    List the accommodations or services you are requesting for the academic setting (for example, test-taking accommodations, interpreters, alternate format textbooks). * (Selection is Required)
  7.  
    Have you requested on-campus housing? If so, please specify the residence hall or note Student and Family Housing * (Selection is Required)
  8.  
    Describe how your disability affects you in a residential setting (residence halls, dining, etc.). * (Selection is Required)
  9.  
    List the disability-related accommodations you are requesting in University Housing. * (Selection is Required)
  10.  
    Describe any accommodations, assistive technology, or services that you anticipate using while at SOU (for example: service dog, assistive listening device, alternate format textbooks). * (Selection is Required)
  11.  
    List any disability accommodations or services you used in high school, on national standardized exams (SAT/ACT, etc.), and/or in previous colleges. * (Selection is Required)
  12.  
    Please review SOU's documentation guidelines at inside.sou.edu/dr and submit appropriate documentation for your disability. Online submission using this site is a secure method. * (Selection is Required)
  13.  
    I authorize Disability Resources to discuss my documentation with the clinician who authored the documentation if additional information or clarification is required. * (Selection is Required)
  14.  
    By submitting this form, I certify that the information provided is accurate and that I am the student or prospective student to whom it refers. * (Selection is Required)
Licensed to Accessible Information Management LLC . Copyright © 2010-2024 by Haris Gunadi. All rights reserved.