VCT Course Request Request
VCT Credit Course Request Form
*For use by current Cisco College students ONLY
Cisco College Student ID (can be found on Campus Connect):
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Last Name:
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First Name:
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Address:
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City:
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State:
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ZIP:
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Phone Number:
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Email Address:
Course Prefix and Number (i.e. GOVT 2306):
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Course Title (i.e. State Government):
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Provider College (Cisco College is the Host College. The Provider College is the remote college offering the course.)
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Instructor:
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Course Start Date:
RadDatePicker
RadDatePicker
Open the calendar popup.
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Course End Date:
RadDatePicker
RadDatePicker
Open the calendar popup.
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Please indicate that you have read and understand the VCT reservation procedures by clicking the checkbox beside each statement.

I have read the VCT reservation procedures and I understand that:
I cannot reserve a VCT space if Cisco College is offering the same course online and space is available.
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My reservation request will be honored only if the VCT course and instructor are approved and space is available.
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If I must withdraw from the VCT course, I will contact the Cisco College VCT Coordinator by email or phone.
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The deadline for VCT submission for a reservation is one week prior to the first day of class.
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Cisco College charges a non-refundable $50 fee in addition to standard tuition and fees for each seat reserved in a VCT course.
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