Full Name (As Listed On WC Records)

First	Middle	Last

Phone Number

The name that you provide on this form will be verified with Waycross College records to ensure that you are a currently enrolled student. By submitting this form you are indicating that you understand and agree to the following conditions. You must abide by the e-mail requirements and / or restrictions in the Electronic Mail Policy and the Campus Network and Computer Acceptable Use Policy. You will be held responsible for all activities performed using this account. It is your responsibility to keep your e-mail account private and secure.

Reminder: Once your request is submitted, come by Computer Services (Administration Building Room 134) and pick up your student e-mail information. Your student e-mail account will be ready within minutes after the request has been submitted. Account information may be picked up during normal business hours.