DRC Application

Disability Resource Center
University of Nevada, Las Vegas

* indicates required field..

Contact Information

Student Name *

Email *

Rebel Email

Street *

City *

State *

Zipcode *

Home Phone *

V (Phone Type)

TTY (Phone Type)

Student L Number

Prospective Student Status

Researching Schools

In University Application Process

Admitted to UNLV

Anticipated semester or quarter of entry *

Are you a transfer student?

Yes

Current Student Status:

High School Junior

High School Senior

UNLV Freshman

UNLV Sophomore

UNLV Junior

UNLV Senior

Other

Disability Information:

Learning Disability

Attention Deficit Disorder

Deaf or Hard of Hearing

Blind or Visually Impaired

Physical or Mobility Impairment

Chronic or Degenerative Disorder

Psychological Disorder

Traumatic Brain Injury

Autism/Asperger's Syndrome

Temporary Disability

Other

Academic Assistance:
Please describe specific services and accommodations that you believe will help you to effectively function at the University of Nevada, Las Vegas.

Special Housing Requirements:
Please describe the housing assistance you believe you will need (single room, dietary restrictions)

NOTE: Personal aids and services fall outside the scope of the Disability Resource Center (i.e. attendant care, hearing aids and other personally prescribed equipment, transportation, and sources of financial aid). It is a student's responsibility to arrange for these services. Please add additional information or comments.