Instructor Validation Form

To receive access to "instructor only" areas on this website, we must first confirm your status as an instructor. Please complete the brief form below, then select the "submit form" button below. Our staff will then verify with your institution that you are an instructor. If you are approved, a username and password will be e-mailed to you within 48 hours. Your username and password will give you access to ALL "instructor only" sections on this website.

All fields are required. Your request cannot be processed if this form is not completed in its entirety.

Name:
Department:
Department Contact Information:
Contact Name:
Phone:
School Name:
Type of School:	Please Select Type High School 2 Year 4 Year Other
School Address:
City:
State:
Zip:
Phone: (daytime)
E-mail:	Yes, I would like to receive monthly newsletters.