SDS New Student Registration Request

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Student Information

Please enter your information
Date of BirthRequired
Please use your university issued email address
What is the best way to reach you?Required




Please select if either of the following applies to you:


Accessibility Specific Information

Instructions: Please tell us about your disability and how it impacts you in the academic setting and in your daily life. If you do not have a formal diagnosis, please indicate this in the space below and describe your current challenges. If undiagnosed, please specify your current status below.
Undiagnosed, if applicable


Are you requesting housing accommodations?
Upload supporting document(s)

Demographic Information

All personal and disability information will be kept confidential and will be used for the following specified purposes: Student demographic data and record keeping, program eligibility, program evaluation, student needs assessment, federal reporting, and other administrative purposes.
Racial BackgroundRequired
Select all that apply.
Ethnic Background: Hispanic/LatinxRequired
Gender IdentityRequired
Are you a first generation student/First Time In Any College (FITIAC) student?Required
Have either of your parents/guardians graduated from a 4-year institution?
Are you a Transfer student (coming from community college or another college/university)?Required
Do you receive a Pell Grant?Required
Please check this box to indicate that all information provided on this form is true and complete to the best of your knowledge.Required