IMPORTANT:

​You MUST have an ORI number before making your appointment.

 Please PRINT & FILL OUT this application and bring it with you to your appointment.

PHOTO REQUIRED.
This is usually for Clearinghouse ORIs that begin with EAHCA, EDOH, EDOEA, VDOE, EDCF, EAPD, EDJJ, VDJJ.
*Note: if your ORI begins with EDCF, we will also need an OCA Number.
​
NO PHOTO REQUIRED.
This is usually for Clearinghouse ORIs that being with FL.