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Online Student Application

Two easy steps to register
Registering with the Office for Disability Accommodations (ODA) is a two step process involving:

1. Completion of an ODA Application and Consent Form
2. Submission of disability documentation

Students can complete the online application below or download an application from the ODA’s Web site at . On ODA’s home page, click on the link Register for Services then go to Step 1. For a description of the disability documentation that is needed, please go to same link on ODA’s Web site and see the guidance provided under Step 2.

Students are responsible for ensuring that their disability documentation has been forwarded to ODA. Accommodations will be provided only after ODA receives and approves a student’s application and disability documentation. Students requesting accessible campus housing should indicate their medical needs on the Residence Housing Application.

For more information, please contact ODA at 601.266.5024 or 228.214.3232. Persons with hearing impairments can use the Mississippi Relay Service by dialing 7.1.1 or 1.800.582.2233 (TTY). Upon request, our office will provide this information in an alternate format, such as electronic file, large print, audio or braille. We look forward to working with you!
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 W number.
  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 (i.e. enter 5417377000 for 541 737 7000).
  2. Hint: Enter 10-digit number only (i.e. enter 5417377000 for 541 737 7000).
  3. Hint: Please use your USM email address (example: yourusername@usm.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)
  4. Campus Location(s)
Questions
  1. Treatment, therapy or medications?*
  2. Is Treatment Helping?*
  3. Any Side Effects from Treatment?*
  4. I hereby authorize The University of Southern Mississippi's Office for Disability Accommodations to communicate with the following: (Please Check all that Apply)
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