Disability Support Services - Bellevue Community College DSS Request Form

This is your first step to receive your accommodations.
This form lets us know that you are registered for the quarter and need DSS to generate your instructor letters identifying your accommodations. You must complete this form as soon as possible after you register for classes! If we do not receive this form, accommodations will not be set up for you.

Your Name

Student ID

Date

Quarter

Date Of Birth

Do you use audio textbooks?

If yes do you plan to use them during the upcoming quarter?

Are you funded by the Division of Vocational Rehabilitation? (DVR) or, Department of Services For The Blind? (DSB)

If yes, please ask your DVR or DSB councilor if you should require your tuition deferred to eliminate the possibility of being dropped from your classes for non–payment.

Please include a copy of your class schedule. Schedules can be retrieved on the BCC website, or at the student kiosk at the Student Services Center next to the bookstore.

Allow 48 hours for your request to be processed.

Please make sure you complete all fields of this form.