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Online Student Application

Two easy steps to register
Welcome and thank you for your interest in applying for accommodations through the Disability Support Services (DSS) Office at Loyola Marymount University. This form is to be completed by the student. Information provided on this application will be treated as confidential. Even though you will be submitting additional documentation along with this application, it is important that you respond to all the questions as best as you can. Under the Additional Information box, only indicate the disabilities for which you plan on submitting supporting documentation. If you need assistance, please seek help from the DSS Office at (310) 338-4216. Please only click submit once.
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)

    General Category

    Neurocognitive Disorders

    Neurodevelopmental Disorders

    Physical Disability

    Psychiatric and Other Mental Disorders

    Sleep-Wake Disorders

    Temporary Condition

  6. Affiliation(s)
  7. Ethnicity(ies)
Please select accommodations and services that you have received PRIOR to registering with our DSS office. This can be accommodations and services provided at your High School or other College/University. If you have not had accommodations in the past, please leave this section blank

Prior Accommodations

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing
Others
Notetaking Services
Classroom Access
Housing
Please select services you are SEEKING to request from the DSS Office. You will also need to submit documentation that establishes your disability and supports your need for the accommodations being requested.

Requesting Accommodations at DSS

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing
Others
Classroom Access
Housing

Questions

  4.  
    Besides the accommodations listed above, are there other accommodations you feel you will need based on your disability? * (Selection is Required)
  5.  
    Did you have accommodations on your college entrance exams (i.e., ACT, SAT, GRE, etc.)? * (Selection is Required)
  6.  
    Have you had accommodations from a previous school, college, and/or university? * (Selection is Required)
  9.  
    I confirm that I completed this application on my own. * (Selection is Required)
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