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Getting Started Form

Two easy steps to register

Note: All fields with * are required fields.

Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 9 alpha numeric characters.
  4. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only (i.e. enter 5417377000 for 541 737 7000).
  2. Hint: Enter 10-digit number only (i.e. enter 5417377000 for 541 737 7000).
  3. Hint: Please use your Clark email address if you have one.
Local Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Questions
  1. What brings you to Disability Support Services?
  2. Have you used accommodations in the past?
  3. Please indicate the type and nature of disability you experience.
  4. Functional Limitations- I have difficulty with:
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