<%option explicit%> <%response.buffer=true%> Student Request for Approval to take an ECC On-Line Course

Edgecombe Community College
Online Assessment Center

Issue an OAC Authorization Code to a Student

This form will create a record in the OAC database and email the student.

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Student Data
(All fields are required...fill in all boxes)

        First Name...........................

        Middle Name.......................

        Last Name...........................

        Non-IMAIL Address............
                                                         (Please proof-read the above email address for typos)

        Social Security Number (digits only).....

        Reason: Passed Assessment
                        Credit for CIS 110/111/113
                        Has completed previous online courses
                        Vouched for by
                                               OAC

Password

(Please review the above data for accuracy before clicking on the submit button)

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