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Online Student Application

Two easy steps to register
Please allow enough time to complete the following form. Some questions will require short answer responses.

Contact the Disability Resource Center (DRC) at (702) 895-0866 or via email at drc@unlv.edu if you require assistance completing this application.

Thank you.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Hint: If you do not have an NSHE number, enter your 10-digit telephone number without dashes.
  3. 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.
  3. Hint: If you do not have a UNLV-issued email address, enter an alternative email address.
Additional Information
  1. Secondary Disability(ies)

    ADD/ADHD

    Allergies/Environmental Illnesses

    Autism Spectrum Disorder

    Cognitive

    Gastrointestinal Disorders

    General Category

    Hearing

    Immune Deficiencies

    Intellectual Disability

    Learning Disability

    Metabolic Disorders

    Neurological

    Other Health Related

    Physical

    Psychological

    Speech/Language

    Substance Abuse

    Temporary

    Visual

  2. Affiliation(s)
  3. Campus Location(s)
Questions
  1.  
    Are you admitted to UNLV? * (Selection is Required)
  2.  
    Are you a returning student? * (Selection is Required)
  3.  
    Will you be under 18-years old when you start classes? * (Selection is Required)
  4.  
    Please indicate your academic status. * (Selection is Required)
  5.  
    Do you have disability-related documentation from a licensed professional? * (Selection is Required)
  6.  
    What are your housing arrangements? * (Selection is Required)
  7.  
    Are you requesting disability-related housing accommodations? * (Selection is Required)
  8.  
    Do you use any of the following mobility aids on campus? (Select all that apply):
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