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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 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)


    Allergies/Environmental Illnesses

    Autism Spectrum Disorder


    Gastrointestinal Disorders

    General Category


    Immune Deficiencies

    Intellectual Disability

    Learning Disability

    Metabolic Disorders


    Other Health Related




    Substance Abuse



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