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Online Student Application

Two easy steps to register
To get accommodations, you first register with the CDS Office. We will collect information about you and your disability or barriers. We are required by law to keep this information confidential.

Not all disabilities are easy to see or understand. The application and documentation process helps explain your barriers and assists in meeting eligibility requirements for certain accommodations. This process is a way for us to gather information about how to better support you in your academic career. It is not meant to be a barrier to obtain services, accommodations or support. You can fill out as much or as little of the application out that you feel comfortable.

If you require assistance obtaining information, documentation, navigating the process or would like any forms in an accessible format, just notify the CDS Staff.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 9 alpha numeric characters.
  8. 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
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address

  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Secondary Disability(ies)

    1 Developmental, Learning Disability & Neurodivergence

    2 Medical & Chronic Health Conditions

    3 Neurological

    4 Physical & Mobility

    5 Psychological & Chronic Mental Health

    6 Sensory

    7 Temporary/Acute Conditions

    General Category

  6. Affiliation(s)
  7. Ethnicity(ies)
  8. Campus Location(s)

Questions

  1.  
    Do you need an interpreter? ¿Necesita un intérprete? * (Selection is Required)
  2.  
    Who referred you to the CDS Office, or how did you find out about us? (Optional)
  3.  
    Washington State Required Question: If you are not registered to vote where you live now, would you like to register to vote now? * (Selection is Required)
  4.  
    Are you a “College in the High School” student? (You are planning to receive college credit for classes that you’re currently taking in High School.) (Required)
  5.  
    Are you currently enrolled in classes? (Required)
  6.  
    If you are already enrolled, how far in your program are you? (Optional)
  7.  
    What are your educational goals at EvCC? (Optional)
  9.  
    How long have you been experiencing this? (Optional)
  10.  
    What prompted you to contact the Center for Disability Services office? (Optional)
  11.  
    What information or documentation are you providing to support your accommodation request? (Check all that apply) (Optional)
  12.  
    Do you need assistance obtaining information or documentation about your disability? (Optional)
  13.  
    How do your disability-related barriers impact you at school or at home? (Optional)
  14.  
    What has been helpful in the past to reduce or eliminate these barriers? (Optional)
  15.  
    Does your condition impact your attendance? (Optional)
  16.  
    Are you requesting accommodations for EvCC Housing? * (Selection is Required)
  17.  
    Housing-Specific Accommodations: If you are requesting a housing accommodation for EvCC Housing, please select here (Optional)
  18.  
    Are you requesting accommodations for EvCC Classes? * (Selection is Required)
  19.  
    Have you ever used classroom accommodations in school before? (Optional)
  20.  
    Are there specific accommodations that you are requesting for your classes at EvCC? (Optional)
  21.  
    Health-Specific Accommodations (Optional)
  22.  
    Do you have any other information that you would like to share? (Optional)
  23.  
    Once you Submit this form, we will schedule an Intake Appointment. Our Intake Appointments are scheduled as ZOOM VIRTUAL MEETINGS by default.
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