DRA Application for Services

Northland Pioneer College Disability Resource and AccessNorthland Pioneer College embraces both the letter and the spirit of the Americans with Disabilities Act, its amendments and Section 504 of the Rehabilitation Act.  The purpose of these laws is to create an environment of equal access for students with disabilities. Any student interested in receiving academic accommodations can start by submitting the requested information below.

By submitting this form, you are providing this information to Northland Pioneer College's Disability Resource Coordinator and grant permission to contact your vocational rehabilitation counselor, veterans counselor or therapist/physician.

If you need help completing this application, please ask for assistance.
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Personal Information

Please enter your NPC Student Identification Number

The address where the Post Office delivers your mail, either a street address or PO Box number.

Your street number and name … or directions to reach your home.

Enter the 2-letter postal abbreviation

Please enter your 5-digit postal ZIP code.

Primary phone number where we could reach you. Please include Area Code.

xxx-xxx-xxxx

A possible second phone number where we could reach you, such as a cell phone. Please include Area Code.

xxx-xxx-xxxx

Please supply your email address.

Please select your date of birth or click on the calendar icon and pick your date of birth.

Required Fields *