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Online Student Application
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Personal Information
Start Term
*
:
Select One
2020 - Summer
2020 - Fall
2021 - Winter
2021 - Spring
2021 - Summer
2021 - Fall
2022 - Winter
2022 - Spring
2022 - Summer
2022 - Fall
2023 - Winter
2023 - Spring
2023 - Summer
2023 - Fall
2024 - Winter
2024 - Spring
2024 - Summer
2024 - Fall
2025 - Winter
2025 - Spring
2025 - Summer
2025 - Fall
2026 - Winter
2026 - Spring
2026 - Summer
2026 - Fall
2027 - Winter
2027 - Spring
2027 - Summer
2027 - Fall
2028 - Winter
2028 - Spring
2028 - Summer
2028 - Fall
2029 - Winter
2029 - Spring
2029 - Summer
2029 - Fall
2030 - Winter
2030 - Spring
2030 - Summer
2030 - Fall
2031 - Winter
2031 - Spring
2031 - Summer
2031 - Fall
2032 - Winter
2032 - Spring
2032 - Summer
2032 - Fall
2033 - Winter
2033 - Spring
2033 - Summer
2033 - Fall
2034 - Winter
2034 - Spring
2034 - Summer
2034 - Fall
2035 - Winter
2035 - Spring
2035 - Summer
2035 - Fall
Note: Select when you would like to start your services.
Expected Graduation Term:
Select One
2008 - Winter
2008 - Spring
2008 - Summer
2008 - Fall
2009 - Winter
2009 - Spring
2009 - Summer
2009 - Fall
2010 - Winter
2010 - Spring
2010 - Summer
2010 - Fall
2011 - Winter
2011 - Spring
2011 - Summer
2011 - Fall
2012 - Winter
2012 - Spring
2012 - Summer
2012 - Fall
2013 - Winter
2013 - Spring
2013 - Summer
2013 - Fall
2014 - Winter
2014 - Spring
2014 - Summer
2014 - Fall
2015 - Winter
2015 - Spring
2015 - Summer
2015 - Fall
2016 - Winter
2016 - Spring
2016 - Summer
2016 - Fall
2017 - Winter
2017 - Spring
2017 - Summer
2017 - Fall
2018 - Winter
2018 - Spring
2018 - Summer
2018 - Fall
2019 - Winter
2019 - Spring
2019 - Summer
2019 - Fall
2020 - Winter
2020 - Spring
2020 - Summer
2020 - Fall
2021 - Winter
2021 - Spring
2021 - Summer
2021 - Fall
2022 - Winter
2022 - Spring
2022 - Summer
2022 - Fall
2023 - Winter
2023 - Spring
2023 - Summer
2023 - Fall
2024 - Winter
2024 - Spring
2024 - Summer
2024 - Fall
2025 - Winter
2025 - Spring
2025 - Summer
2025 - Fall
2026 - Winter
2026 - Spring
2026 - Summer
2026 - Fall
2027 - Winter
2027 - Spring
2027 - Summer
2027 - Fall
2028 - Winter
2028 - Spring
2028 - Summer
2028 - Fall
2029 - Winter
2029 - Spring
2029 - Summer
2029 - Fall
2030 - Winter
2030 - Spring
2030 - Summer
2030 - Fall
2031 - Winter
2031 - Spring
2031 - Summer
2031 - Fall
2032 - Winter
2032 - Spring
2032 - Summer
2032 - Fall
2033 - Winter
2033 - Spring
2033 - Summer
2033 - Fall
2034 - Winter
2034 - Spring
2034 - Summer
2034 - Fall
2035 - Winter
2035 - Spring
2035 - Summer
2035 - Fall
Note: Select when you plan to graduate.
First Name
*
:
Last Name
*
:
Middle Name:
Optional: Preferred Name:
Student ID:
Hint: Enter 9 alpha numeric characters.
Birth Date:
Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Gender
*
:
Select One
Female
Genderqueer/Gender Non-conforming
Male
Not Specified
Prefer Not to Say
Trans Man
Trans Woman
Contact Information
Primary Phone Number:
Hint: Enter 10-digit number only.
Secondary Phone Number:
Hint: Enter 10-digit number only.
Email Address
*
:
Local Address
Address
*
:
City
*
:
State
*
:
Select One
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
International
Zipcode
*
:
Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
Same as Local Address
Address:
City:
State:
Select One
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
International
Zipcode:
Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
Primary Disability
*
:
Select One
=== General Category ===
ADD
ADHD
Autism Spectrum Disorder
Communication
COVID-19
Deaf/HOH
Functional
Learning Disability
Medical
Mental Health
Mobility Impaired
Not Qualified
Visually Impaired
X - Other
Secondary Disability(ies)
General Category
ADD
ADHD
Autism Spectrum Disorder
Communication
COVID-19
Deaf/HOH
Functional
Learning Disability
Medical
Mental Health
Mobility Impaired
Not Qualified
Visually Impaired
X - Other
Other Disability or Note:
Seeking Degree:
Select One
Certificate Program
Credential
Ed.D Degree
Master Degree
Post Baccalaureate
Undergraduate
Major:
Select One
Accountancy (MS)
Advertising (BS)
Aerospace Engineering (BS)
Aerospace Engineering (MS)
African-American Studies (BA)
Anthropology (BA)
Applied Mathematics, Concentration in Applied and Computational Mathematics (BS)
Applied Mathematics, Concentration in Economics and Actuarial Science (BS)
Applied Mathematics, Concentration in Statistics (BS)
Archives and Records Administration (MARA)
Art, Animation/Illustration (BF)
Art, Art History and Visual Culture (MA)
Art, Concentration in Art History and Visual Culture (BA)
Art, Concentration in Design Studies (BA)
Art, Concentration in Digital Media Art (BF)
Art, Concentration in Photography (BF)
Art, Concentration in Pictorial Art (BF)
Art, Concentration in Spatial Art (BF)
Art, Concentration Studio Practice (BA)
Art, Concentration Studio Practice-Preparation for Teaching (BA)
Art, Digital Media Art (MFA)
Art, Photography (MFA)
Art, Pictorial Art (MFA)
Art, Spatial Art (MFA)
Athletic Training (BS)
Aviation (BS)
Behavioral Science (BA)
Biological Science (BA)
Biological Science, Concentration in Ecology and Evolution (BS)
Biological Science, Concentration in Marine Biology (BS)
Biological Science, Concentration in Microbiology (BS)
Biological Science, Concentration in Molecular Biology (BS)
Biological Science, Concentration in Systems Physiology (BS)
Biological Sciences (MA)
Biological Sciences, Concentration in Ecology and Evolution (MS)
Biological Sciences, Concentration in Molecular Biology and Microbiology (MS)
Biological Sciences, Concentration in Physiology (MS)
Biomedical Engineering (BS)
Biomedical Engineering (MS)
Biomedical Engineering, Concentration in Biomedical Devices (MS)
Biotechnology (MBT)
Business Administration, Concentration in Accounting (BS)
Business Administration, Concentration in Accounting Information Systems (BS)
Business Administration, Concentration in Business Analytics (BS)
Business Administration, Concentration in Corporate Accounting and Finance (BS)
Business Administration, Concentration in Entrepreneurship (BS)
Business Administration, Concentration in Finance (BS)
Business Administration, Concentration in General Business (BS)
Business Administration, Concentration in Global Operations Management (BS)
Business Administration, Concentration in Human Resource Management (BS)
Business Administration, Concentration in International Business (BS)
Business Administration, Concentration in Management (BS)
Business Administration, Concentration in Management Information Systems (BS)
Business Administration, Concentration in Marketing (BS)
Chemical Engineering (BS)
Chemical Engineering (MS)
Chemistry (BA)
Chemistry (BS)
Chemistry (MA)
Chemistry (MS)
Chemistry, Concentration in Biochemistry (BS)
Child and Adolescent Development (BA)
Child and Adolescent Development (MA)
Child and Adolescent Development, Preparation for Teaching (BA)
Chinese (BA)
Civil Engineering (BS)
Civil Engineering (MS)
Communication Studies (BA)
Communication Studies (MA)
Communication Studies, Preparation for Teaching (BA)
Communicative Disorders and Sciences (BA)
Computer Engineering (BS)
Computer Engineering (MS)
Computer Science (BS)
Computer Science (MS)
Creative Arts (BA)
Creative Arts, Preparation for Teaching (BA)
Dance (BA)
Dance (BF)
Doctor of Nursing Practitioner (DNP)
Early Career MBA (MBA)
Earth Science (BA)
Economics (BA)
Economics (BS)
Economics (MA)
Economics, Concentration in Applied Economics (MA)
Education, Concentration in Counseling and Student Personnel (MA)
Education, Concentration in Special Education (MA)
Education, Concentration in Speech Pathology (MA)
Educational Leadership (EdD)
Educational Leadership, Concentration in Administration and Supervision (MA)
Educational Leadership, Higher Education Administration (MA)
Electrical Engineering (BS)
Electrical Engineering (MS)
Elementary Education, Concentration in Curriculum and Instruction (MA)
Engineering (MS)
Engineering Management (MS)
Engineering, Concentration in Electronic Materials and Devices (MS)
English (BA)
English (MA)
English, Concentration in Creative Writing (BA)
English, Concentration in Preparation for Teaching (BA)
English, Concentration in Professional and Technical Writing (BA)
English, Creative Writing (MFA)
Environmental Studies (BA)
Environmental Studies (BS)
Environmental Studies (MS)
Environmental Studies, Concentration in Energy (BS)
Environmental Studies, Concentration in Environmental Impact Assessment (BS)
Environmental Studies, Concentration in Environmental Restoration and Resource Management (BS)
Environmental Studies, Preparation for Teaching (BA)
Forensic Science, Concentration in Biology (BS)
Forensic Science, Concentration in Chemistry (BS)
French (BA)
French (MA)
French, Concentration in Preparation for Teaching (BA)
General Engineering (BS)
Geography (BA)
Geography (MA)
Geology (BS)
Geology (MS)
Global Studies (BA)
Graphic Design (BF)
Health Science (BS)
Health Science, Concentration in Health Services Administration (BS)
History (BA)
History (MA)
History, Concentration in History Education (MA)
Hospitality, Tourism, and Event Management (BS)
Human Factors/Ergonomics (MS)
Humanities, Concentration in American Studies (BA)
Humanities, Concentration in Asian Studies (BA)
Humanities, Concentration in European Studies (BA)
Humanities, Concentration in Liberal Arts (BA)
Humanities, Concentration in Middle East Studies (BA)
Humanities, Concentration in Religious Studies (BA)
Industrial and Systems Engineering (BS)
Industrial and Systems Engineering (MS)
Industrial Design (BS)
Industrial Studies, Concentration in Computer Electronics and Network Technology (BS)
Industrial Technology, Concentration in Manufacturing Systems (BS)
Interdisciplinary Studies (MA)
Interdisciplinary Studies (MS)
Interior Design (BF)
Japanese (BA)
Journalism (BS)
Justice Studies (BS)
Justice Studies (MS)
Justice Studies, Concentration in Criminology (BS)
Kinesiology (BS)
Kinesiology (MA)
Kinesiology, Preparation for Teaching (BS)
Liberal Studies, Concentration in Cross-Cultural Studies in Mexican and American Education (BA)
Liberal Studies, Preparation for Teaching (BA)
Library and Information Science (MLIS)
Linguistics (BA)
Linguistics (MA)
Marine Science (MS)
Mass Communication (MS)
Materials Engineering (BS)
Materials Engineering (MS)
Mathematics (BA)
Mathematics (MA)
Mathematics (MS)
Mathematics, Concentration in Mathematics Education (MA)
Mathematics, Preparation for Teaching (BA)
MBA for Professionals (MBA)
Mechanical Engineering (BS)
Mechanical Engineering (MS)
Medical Product Development Management (MS)
Meteorology (BS)
Meteorology (MS)
Meteorology, Concentration in Climate Science (BS)
Mexican American Studies (MA)
Music (BA)
Music (MM)
Music, Concentration in Composition (BM)
Music, Concentration in Jazz Studies (BM)
Music, Concentration in Music Education (BM)
Music, Concentration in Performance (BM)
Nursing (BS)
Nursing (MS)
Nursing, Concentration RN to BSN (BS)
Nutritional Science (BS)
Nutritional Science (MS)
Nutritional Science, Concentration in Dietetics (BS)
Nutritional Science, Concentration in Packaging (BS)
Occupational Therapy (MS)
Organizational Studies (BA)
Philosophy (BA)
Philosophy (MA)
Physics (BA)
Physics (BS)
Physics (MS)
Physics, Concentration in Computational Physics (MS)
Physics, Concentration in Modern Optics (MS)
Physics, Preparation for Teaching (BA)
Political Science (BA)
Psychology (BA)
Psychology (BS)
Psychology, Concentration in Clinical Psychology (MS)
Psychology, Concentration in Industrial/Organizational Psychology (MS)
Psychology, Concentration in Research and Experimental Psychology (MA)
Public Administration (MA)
Public Health (MPH)
Public Relations (BS)
Quality Assurance (MS)
Radio-Television-Film (BA)
Recreation (BS)
Recreation (MS)
Recreation, Concentration in International Tourism (MS)
Recreation, Concentration in Recreation Management (BS)
Recreation, Concentration in Therapeutic Recreation (BS)
Science Education (MA)
Social Science (BA)
Social Science, Preparation for Teaching (Multiple Subject) (BA)
Social Science, Preparation for Teaching (Single Subject) (BA)
Social Work (BA)
Social Work (MSW)
Sociology (BA)
Sociology (MA)
Sociology, Concentration in Community Change (BA)
Sociology, Concentration in Race and Ethnic Studies (BA)
Sociology, Concentration in Social Interaction (BA)
Sociology, Concentration in Women, Gender, and Sexuality Studies (BA)
Software Engineering (BS)
Software Engineering (MS)
Software Engineering, Concentration in Cybersecurity (MS)
Spanish (BA)
Spanish (MA)
Spanish, Preparation for Teaching (BA)
Statistics (MS)
Taxation (MS)
Teaching English to Speakers of Other Languages (MA)
Theatre Arts (BA)
Theatre Arts (MA)
Theatre Arts, Preparation for Teaching (BA)
Transportation Management (MS)
Undeclared
Urban Planning (MUP)
Affiliation(s)
Department of Rehabilitation (DOR)
Educational Opportunity Program (EOP)
Student Athlete
Veterans
Ethnicity(ies)
African-American
Asian or Pacific Islander
Decline to State
European-American
Hispanic or Latino
Middle Eastern or North African Descent
Multi-Racial
Native American
Other
Campus Location(s)
LO #1 Counselor Response - N/A
LO #1 Counselor Response - NO
LO #1 Counselor Response - Somewhat
LO #1 Counselor Response - YES
LO #2 Counselor Response - N/A
LO #2 Counselor Response - NO
LO #2 Counselor Response - Somewhat
LO #2 Counselor Response - YES
LO#1 Met Objective - N/A
LO#1 Met Objective - NO
LO#1 Met Objective - Somewhat
LO#1 Met Objective - YES
LO#2 Met Objective - N/A
LO#2 Met Objective - NO
LO#2 Met Objective - Somewhat
LO#2 Met Objective - YES
Additional Note:
Questions
Can you name your disability(ies)?
Yes
No
Somewhat
Additional Note or Comment
What is the name of your disability(ies)? If the particular name of your disability(ies) is not coming to mind, simply explain what the disability(ies) is in a few words.
*
Can you provide at least one example of how your disability(ies) impacts you in your daily activities (i.e., in the classroom, studying, taking tests, reading, etc.)?
Yes
No
Somewhat
Additional Note or Comment
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