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Online Student Application

Two easy steps to register
Welcome to AIM! In order to register for services, students must complete the application below. Please carefully read and answer all the of the questions to the best of your abilities. Instructions will be provided for the next step once you have completed and submitted your application.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 8 numeric characters.
  8. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)

Questions

  1.  
    What is the reason for this meeting? Please check all the apply.
  3.  
    Is this your first semester at Montclair State University? * (Selection is Required)
  4.  
    Are you a visiting student? If yes, which college/university do you attend?
  5.  
    Are you a transfer student? If yes, where are you transferring from and did you receive your Associates Degree?
  11.  
    Are you currently receiving services from government rehabilitation agency? Choose from the following:
  12.  
    Emergency Preparedness: Do you require the use of an elevator? * (Selection is Required)
  13.  
    Emergency Preparedness: Can you go up/down stairs? * (Selection is Required)
  14.  
    Emergency Preparedness: Will you require assistance in an emergency situation? If yes, please explain. * (Selection is Required)
  15.  
    How did you hear about the Disability Resource Center?
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