New Student Registration Form

This form is for students who have never received disability services through our office. Please complete this form to begin the registration process with the Learning Assistance Center’s Disability Services Office. Once we receive your information, we’ll be in contact with you via your @maine.edu email address to set up an appointment.

First Name *

Enter your legal first name.

Last Name *

Enter your legal last name.

Preferred / Chosen Name if Different from Above

If you prefer to go by a name that is different from what you listed above, please tell us what it is.

Preferred / Chosen Pronouns *

Please tell us any preferred pronouns you use (ex: she/her/hers, he/him/his, they/them/their)

@maine.edu Email address *

Enter your UMF email address.

Date of Birth *

Enter your date of birth

Phone Number *

Please include area code

Tell us why you'd like to register with the Learning Assistance Center's Disability Services *

I have a documented disability.

I have a temporary disability.

I think I may have a disability, but I don't have documentation or a diagnosis.

I would like to apply for housing accommodations

I have a medical concern related to Covid-19 (pre-existing condition or documented inability to wear a face covering)

OtherOther

Please check all that apply.

Do you receive services from either Vocational Rehabilitation or the Veterans Administration

Yes

If you previously received accommodations at school or in your workplace, please briefly describe what they were and how they helped you.

Are there barriers or challenges that you are currently experiencing or that you anticipate experiencing in your classes? If so, please briefly tell us about them.

In anticipation of our first meeting, if you have any specific questions, please list them here. We'll do our best to address them when we meet.

New Student Registration Form

Campus

Admissions

Resources