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Online Student Application

Two easy steps to register
Welcome to the Rice Disability Resource Center Online Accommodation Request Form.

Please complete the form below in it's entirety.
Contact the Disability Resource Center if you have any questions at 713-348-5841 or e-mail to adarice@rice.edu


Step 1: Complete this accommodation request form.

Step 2: You can submit any supporting documentation you have when you complete this form. (Please review the Rice Disability Resource Center Documentation Guidelines at https://drc.rice.edu)

Step 3: We will review the information you submitted and follow up with you regarding the next steps.
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.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Secondary Disability(ies)

    ADHD

    General Category

    Hearing Impairment

    Learning Disabilities

    Medical/Physical

    Psychological Disorder

    Temporary Disability

    Visual Impairment

  5. Affiliation(s)
  6. Ethnicity(ies)
Select the accommodations that you are requesting.

Requesting Accommodations at DRC

Alternative Testing
Housing Accommodations
Temporary Accommodations
Academic Accommodations

Questions

  1.  
    What is your status at Rice? * (Selection is Required)
  2.  
    Does your disability affect you in an academic setting? If so, please explain? * (Selection is Required)
  3.  
    If you are a transfer undergraduate student or a graduate student, did you receive any type of disability-related accommodations at a previous college? * (Selection is Required)
  4.  
    List the academic accommodations you are requesting at Rice. (e.g., test-taking accommodations, books in alternative format). * (Selection is Required)
  5.  
    Does your condition affect you in a residential setting (e.g., residence halls, dining halls)? If so, please explain. * (Selection is Required)
  6.  
    List the disability-related accommodations you are requesting in a university-owned residential setting (e.g., strobe alarms, wheelchair-accessible housing), if applicable. * (Selection is Required)
  7.  
    List the temporary disability-related accommodations you are requesting * (Selection is Required)
  8.  
    Please review DRC documentation guidelines at https://drc.rice.edu and submit appropriate documentation for your disability. (Online submission using this site is a secure method of submitting documentation.) Please note that files must be 5MB or less in size. * (Selection is Required)
  9.  
    I understand that it may be necessary for the Disability Resource Center to share information regarding my disability with Rice University personnel who have a legitimate need to know. Among such people with a need to know may be instructors, academic advisors, counseling center, my college Magisters, Athletics Department (if an athlete), academic deans, or others. * (Selection is Required)
  10.  
    I authorize the Disability Resource Center to discuss my disability, accommodations and general progress with my parents or legal guardians. * (Selection is Required)
  11.  
    I authorize the Disability Resource Center to release information, or discuss/secure information about my disability and request for accommodations at Rice University with other person(s) or agencies who have a legitimate need to know. * (Selection is Required)
  12.  
    I understand that all or some of the parts signed on this release can be canceled at any time with a written request to the Disability Resource Center. This authorization will expire one year after completion of my studies at Rice University. * (Selection is Required)
  13.  
    I have read and understand the Grievance Procedures located at https://drc.rice.edu/students/grievances * (Selection is Required)
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