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Request Academic Support Assistance

Name*
Date*
MM slash DD slash YYYY
Student ID#*
Program of Study*
Phone*
LIFE Student Email*

In order to secure information sent via email as much as possible, we will send information to your LIFE email address.
How may we assist you today?
The Academic Support Request Form is for inquiries only. An Academic Support staff member will contact you regarding your inquiry.
e-Signature*

Please type your name. Doing so and submitting the form acts as your signature.

Questions or Comments
If you have any questions or comments, please contact Academic Support at 678.331.4570.