Skip to Main Content Skip to Tabs Skip to Sub-Tab Navigation

Only Housing Accommodations Application

Two easy steps to register
Please use this form to submit your housing accommodation request.
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

Questions

  1.  
    Primary Disability
  2.  
    Is your disability ___ ? * (Selection is Required)
  6.  
    I understand that I need to resubmit documentation and my accommodation request each year. * (Selection is Required)
  7.  
    I understand that purchasing documentation to support my housing accommodation request is prohibited and may result in my application being considered incomplete. * (Selection is Required)
  8.  
    If this request is for an Emotional Support Animal, I certify that I have read the "TAMUCC Rules and Regulations regarding ESAs". * (Selection is Required)
Licensed to Accessible Information Management LLC . Copyright © 2010-2024 by Haris Gunadi. All rights reserved.