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Online Student Application

Two easy steps to register
Welcome to Accessibility Resources. Please complete the form below in it's entirety. This will help us determine the resources that may provide access through your time at BTC.

Please know that the information you provide will be kept private in accordance with the Family Education Rights & Privacy Act (FERPA). For more information on FERPA, please visit: https://www.btc.edu/FERPA
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.
Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Secondary Disability(ies)

    01 Deaf/Hearing

    02 Mobility

    03 Speech/Language

    04 Learning Disability

    05 Blind/Vision

    06 Chronic/Acute Health

    07 Neurological/Nervous System

    08 Psychological/Emotional/Mental Health

    General Category

  5. Affiliation(s)
  6. Ethnicity(ies)
  7. Campus Location(s)

Questions

  1.  
    How did you first learn about Accessibility Resources at BTC? * (Selection is Required)
  2.  
    As a student with a disability:
  3.  
    As a student with a disability:
  4.  
    I am able to describe:
  5.  
    As a student, I feel confident that I can:
  6.  
    Overall, I feel:
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