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Online Student Application

Two easy steps to register
Please fill out this form if you are requesting services from Learning Support Services. If you are not a student with a disability, skip the questions related to disability and academic accommodations.
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 (i.e. enter 5417377000 for 541 737 7000).
  2. Hint: Enter 10-digit number only (i.e. enter 5417377000 for 541 737 7000).
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)
If you are requesting academic accommodations for a disability please select the accommodations you received in high school or from another college/university. If you are not requesting accommodations, please leave this section blank.

Prior Accommodations

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing Access Services
Other
Notetaking Services
Classroom Access
Mobility Device (Student Owned)
If you are requesting academic accommodations for a disability please select the accommodations you received in high school or from another college/university. If you are not requesting accommodations, please leave this section blank.

Requesting Accommodations at LSS

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing Access Services
Other
Notetaking Services
Classroom Access
Mobility Device (Student Owned)
Questions
  1. Which services are you applying for?
  2. Who referred you to Learning Support Services?
  3. Which learning skills do you want to improve?
  4. Are you interested in having an academic coach? If yes, describe your goals for academic coaching below.
  5. Are you a student with a disability requesting academic accommodations? If yes, describe how your disability impacts you in a learning environment below.
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