Register with ARC

Demographic Data

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Student Status



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Disability Information

Note: Documentation of your disability is required in order to receive services. Please submit disability documentation with this application form. See guidelines for documentation of specific disability categories listed on the ARC website








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Support Services and Accommodations

Services are individualized based on functional limitations and requirements of the specific course/instruction. Services are subject to approval by Accessibility Resource Center.









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Confidentiality Statement

Please read, sign and date the following confidentiality and disclosure statement:

I understand that disability related information I provide to Accessibility Resource Center at Chico State is confidential and can only be disclosed at my request except when:

  1. The ARC staff advises university faculty and staff on how to implement a reasonable accommodation I have requested and that I am eligible to use.
  2. The ARC staff consults with university faculty and staff, on a need to know basis, in the event a health and safety issue occurs.
  3. I have received a copy of ARC Student Rights, Responsibilities & Dispute Resolution.
  4. I have been informed of Emergency Preparedness for persons with disabilities.

Typing your name below is valid as a written signature.

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