Registration for Disability Services

* indicates a required field

Student Information

Please enter your information

First Name

Last Name

Middle Name

Preferred Name

Gender

Student ID

LC Palomino ID number (PID)

Laredo College Student Email preferred

Primary Number

Secondary Phone Number

Date of Birth

High School Attended/GED

Date of High School Graduate

(Month/Year)

Emergency Contact

Name

Relationship

(e.g. mother, father, sister)

Emergency Contact Phone Number

Specific Accommodation Information

My diagnosed disability falls into the following category

Other (please specify)

Are you currently seeing a physician for your condition?

Are you an active client of the Texas Workforce Solutions Vocational Rehabilitation Services (TWS-VRS)?

Are you a client of any other Texas State Agency?

Agency Information

If you are a client of any Texas State Agency, may we request records from your counselor and likewise provide them school-related information, such as, but not limited to, grades, course schedule, financial aid information and admission status?

Upload supporting document(s)

Provide Supporting Documentation

Please provide supporting documentation from (1) a medical provider, psychologist, counselor, or social service agency that includes the diagnosis or disability or 2) ARD/504 paperwork from school district. Please email supporting documentation to specialservices@laredo.edu. If supporting documentation is not available or you have any questions, please contact Special Services by calling (956)721-5137.

Once we receive your application and supporting documentation, we will process your request and contact you to set up an appointment to review your paperwork.

Signature

My signature below affirms that I am applying with Laredo College Disability Services as a student with a disability as defined by the Americans with Disabilities Act and Section 504.

I understand that I have the opportunity to participate in college credit courses at LC but do not have a guarantee of success.
I am responsible for meeting or exceeding the minimum academic standards, technical standards, and/or essential functions as set forth by my program of study and the classes I take.
I am responsible for following Laredo College’s Student Code of Conduct and Discipline
I am responsible for submitting an Accommodation Request Form each semester that I am needing accommodations for my current classes. If I need to make a change to my accommodations, I will make an appointment with Disability Services Counselor by calling (956)721-5137.

Please sign your name below: