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Online Student Application

Two easy steps to register
Welcome to Access and Disability Resources at RCC. Please complete the form below in it's entirety. This will help us provide the most appropriate resources.

Please know that the information you provide will be kept private in accordance with the Family Education Rights & Privacy Act (FERPA). For more information on FERPA, please visit: https://web.roguecc.edu/enrollment-services/ferpa
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.
Additional Information
  1. Secondary Disability(ies)

    Chronic/Acute Health

    Communication

    Deafness/Hard of Hearing

    General Category

    Learning Disability

    Low Vision/Blindness

    Mental Health

    Neurological/Nervous System

  2. Affiliation(s)
  3. Campus Location(s)
Please check all the accommodations you had at a previous college or institution.

Prior Accommodations

Alternative Testing
Alternative Formats
Notetaking Services
Classroom Access
Notetaking Technology
Please check all the accommodations you are requesting at RCC.

Requesting Accommodations at Access

Alternative Testing
Alternative Formats
Notetaking Services
Classroom Access
Notetaking Technology
Questions
  1. What is your student status?
  2. Are you requesting services from Access and Disability Resources?
  3. How does your disability impact you in an academic setting? *
  4. Have you received accommodations in the past, either at school or at work? *
  5. Please review the Access Office documentation guidelines at https://web.roguecc.edu/disability-services/documentation and submit appropriate documentation for your disability. Online submission using this site is a secure method. *
  6. I authorize Access and Disability Resources at RCC to discuss my documentation with the clinician who authored the documentation if additional information or clarification is required. *
  7. 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. *

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