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To receive your Charter College Student User Account, fill out the information requested below.

The information you provide below is for the purpose of contacting you when your account has been created. If you do not have a current email address, enter a phone number where you can be reach, or a message can be left for you, during the weekday.

Please not that it can take up to 3 days for your student user account to be created.

First Name:  

Last Name:   

Current E-Mail Address:   

Phone Number:   

Program:

Campus:

Temporary password:
Enter the last 4 digits of your Social Security Number:   

By requesting a student user account, I give consent to have my name published in a weekly list of Student Computer Accounts. I understand that all other information will not be published nor will it be made available for public use.