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Online Student Application

Two easy steps to register
The student should complete this form.
The Student Disability Resource Center's (SDRC) primary mission is to ensure access for students with disabilities to all curricular and co-curricular opportunities offered by Austin Peay State University. It is the responsibility of the student to:
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
  1. Ethnicity(ies)

Questions

  1.  
    What is your classification
  2.  
    Preferred Pronoun * (Selection is Required)
  5.  
    Please state your disability(ies)
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