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Online Student Application

Two easy steps to register
Welcome to UT Martin from the Office of Disability Services (ODS). In order to best serve you, please complete the application below.

The information you provide will be kept private in accordance with the Family Education Rights & Privacy Act (FERPA). For more information on FERPA, please visit:

Note: In accordance with UT Martin IT security standards, you will be logged out after 30 minutes. If you wish to record longer responses to questions, we suggest viewing questions first, then copy & paste pre-prepared answers into the application when ready.

* Please note that it can take up to 30 calendar days to completely process an application request for initial services or add on accommodations. Please email our office at or reach out to Disability Coordinator at 731.881.7605 to discuss your specific needs.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 9 alpha numeric characters.
  4. 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
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address

  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Secondary Disability(ies)

    Acquired Brain Injury


    Autism Spectrum Disorder

    Blind/Visually Impaired

    Chronic/Acute Health

    Deaf/Hard of Hearing

    General Category

    Intellectual Disability

    Learning Disability

    Mental Health Impairment

    Mobility Impairment

    Neurological/Nervous System

    ODS Issued Assistive Technology


  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)
Please check all the accommodations you had at a previous institution.

Prior Accommodations

Alternative Testing
Alternative Formats
Deaf and Hard of Hearing
Classroom Access
Student Health
Course Participation
Please check all the accommodations you are requesting at the University of Tennessee at Martin.

Requesting Accommodations at ODS

Alternative Testing
Alternative Formats
Classroom Access
Student Health
Course Participation
    How did you hear about the Office of Disability Services?
    Will you need disability-related accommodation/accommodations for on-campus housing?
    Please describe the housing accommodation/accommodations and why you need each accommodation as it relates to your specific disability needs and symptoms.
    Please specify when you would like the housing accommodations to begin?
    Do you currently receive services or support through any of the following (check all that apply). * (Selection is Required)
    What is your gender identity? * (Selection is Required)
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