DRC Application

* indicates a required field

Student Information

The DRC is committed to supporting your educational goals by addressing your disability related needs. Services are approved on a case-by-case basis and are determined through an interactive process between the student and a DRC counselor.

To initiate services with the DRC, please complete the following application. It is important that you complete the answers as best as you can.

How did you learn about the Disability Resource Center?Required
*7 numbers
Please use your college issued email address

Please type phone number with dashes. For example: 951-123-4567

Specific Accommodation Information

Are you currently in high school?
Did you have a 504 Plan or IEP in high school?
Have you received accommodations at another college?
Which is your home college:
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Are you a Veteran or a Veteran dependent? Riverside City College has services available to Veterans and families.

https://www.rcc.edu/services/veterans/Pages/Veteran-Services.aspx

Are you interested in information on additional disability support through TRIO programs?

https://www.rcc.edu/student-support/student-support/trio.html

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Are you a dual enrollment student?
California Voter RegistrationRequired
Would you like to register to vote? Please choose one of the following:
Upload supporting document(s), if available

Supporting Documents/Documentation may include:

High School IEP
High School 504 Plan
High School Psychoeducational Report

Disability Verification Form signed by a physician or qualifying professional

A letter written on letterhead and signed by a physician or qualifying professional (for example: therapist, psychologist, medical doctor, case worker, etc.) stating your diagnosis (for letters from private practitioners, please include a license number)

Documents from a Disability Support Services from another college you attended

Student Rights and Responsibilities

Student RightsRequired

My participation in DRC is entirely voluntary.

Receiving support services or instruction through DRC shall not preclude me from participating in any other course, program, or activity offered by the college or from receiving basic academic adjustments required by state and federal law.

I consent for the DRC to keep a copy of my medical records for use in my education/career planning. All records maintained by DRC pertaining to my medical condition(s)/disability(ies) shall be protected from disclosure and shall be subject to all other confidentiality requirements for handling student records.

Student ResponsibilitiesRequired

I will provide DRC with the necessary information, documentation and/or forms (medical, educational, etc.) to verify my disability-related needs.

I will meet with a DRC counselor to complete an Academic Adjustment Plan (AAP).

If I feel any changes are needed to my AAP, I will meet with a DRC counselor to discuss these needs.

I will utilize DRC services in a responsible manner. I understand I must adhere to DRC written service provision, policies, and procedures.

Note: Authorities cited: Title 5 C.C.R. Section 56000 et. seg.

User AgreementRequired

Checking this box indicates that I understand and agree to the above Student Rights and Responsibilities and I will abide by them. I give permission to DRC personnel to discuss my disability-related needs with other professionals who have a legitimate educational need to know. I may print this document using the print capabilities of my browser. Failure to comply with these rights and responsibilities may result in suspension of services. I will have the opportunity to appeal the decision.

If you have any questions or concerns, please contact the DRC office or visit the DRC website at - 

https://www2.rcc.edu/services/disablestudents/Pages/_dsps_home.aspx