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

Get Started

Personal Information
  1. Hint: G01234567
  2. 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. Note: If you already have PCC email address, please provide one.
Additional Information
  1. Note: Select when you would like to start your disability services.
  2. Note: Select when you plan to graduate.
Questions
  1. What brings you to Disability Services
  2. Were you referred by someone?
  3. Did you graduate from high school?*
  4. Did you complete a GED?*
  5. Have you used accommodations in the past?
  6. FUNCTIONAL LIMITATIONS: I have difficulty or may need assistance with:
  7. How do you rate your own self-advocacy skills
Licensed to Accessible Information Management LLC . Copyright © 2010-2017 by Haris Gunadi. All rights reserved.