Student Disability Services Registration Form

* indicates a required field

Student Disability Services Registration Form

Instructions: Please enter the required information below and make sure to enter your UMBC Campus ID correctly. Please upload your disability documentation and attach to this request. If you are unable to upload the documentation, please email us at disability@umbc.edu to let us know how and when you will submit the required documentation.

First Name

Middle Name

Last Name

UMBC Campus ID

2 letters followed by 5 numbers, e.g. ZZ11111, (as found on your myUMBC profile or your UMBC Campus Id card).

Make sure you have entered your UMBC CampusID correctly.

Please use your UMBC issued email address, e.g. ZZ11111@umbc.edu or username1@umbc.edu

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Are you enrolled at UMBC's Shady Grove Campus?

Specific Accommodation Information

Disabling Condition(s)

Please list your diagnosed disability(ies)

Academic Strengths and Skills?

Academic Difficulties/Challenges/Barriers?

Adaptive hardware, assistive technology and/or mobility devices used?

What accommodations are you seeking?

Requested accommodations must be supported by the documentation you submit to us.

Do you need accommodations for placement testing?

For information about Placement Testing (including conditions for exemption), go to https://lrc.umbc.edu/placement-testing/

Do you have documentation of one or more disabilities that you can provide to us?

The documentation you submit must include a diagnosis from a qualified professional. For more information about the required documentation, visit http://sds.umbc.edu/accommodations/registering-with-sds/

Student Disability Services Registration Form

Student Disability Services Registration Form

Specific Accommodation Information

Document Information