Student Registration Form

* indicates a required field

Student Information

Please only submit this form once. You will have as much time as you need to complete this form. However, if there is no activity on the form for 45 minutes, your session will end and your information will be lost.

To request a preferred first name within the University systems, please fill out the Preferred Name Request Form.

(ex. 000123456)
Please use your university issued email address
Upload supporting document(s)

In order to process your registration form, we encourage you to upload any supporting documentation at this time. Please note: Housing accommodation requests require the appropriate documentation form (available on the ODR Housing Accommodations website).

What Type of Accommodations are you requesting?
Please note: Housing accommodation requests must be accompanied by a completed Housing Accommodation Request form (available on the ODR website).

Specific Accommodation Information

Student Health Center ReleaseRequired

Students with chronic health conditions, severe allergies, psychological conditions, or other impacts requiring ongoing care and/or symptom management - are strongly recommended to contact the UMW Health Center in Lee Hall, Rm 112 by Phone at 540-654-1040 or by e-mail at

Would you like to share your documentation with the Student Health Center?