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Online Student Application

Two easy steps to register
I certify that the information recorded on this application is correct, and hereby give my permission to communicate, on a need to know basis, with any MCCCD Department and instructors who will benefit my academic progress for the duration of my education at Maricopa County Community College District (MCCCD).

Please be advised that MCCCD Disability Resources and Services offices (DRS) retain student documentation and disability files in accordance with record retention policies. Please keep your original documentation and make a separate copy for our office. The DRS office cannot return documentation to students.

Please check daily, the email you provided on this application for application status.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Please select campus location where you will be enrolled.
  3. Note: Select when you plan to graduate.
  4. Hint: Enter 10 alpha numeric characters.
  5. 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.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Affiliation(s)
  2. Ethnicity(ies)
  3. Campus Location(s)
Questions
  1. Have you ever registered with a Disability Services Office in Maricopa before? If so, please indicate which campus you registered at in the space provided. *
  2. Are you a... (check all that apply)
  3. If you are a new student to MCCCD, have you attended a New Student Orientation? *
  4. Are you currently enrolled in any Maricopa College course? *
  5. How did you find out about Disability Resources and Services (check all that apply)?
  6. Have you had disability accommodations in the past? *
  7. Do you currently have documentation to verify a disability? (Please note: your application will still be processed if you do not upload documentation at this time) *
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