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CTL Request Form

Do you have a request that you would like the CTL Staff Members to assist you with? Or, do you have other suggestions/comments that will help us better improve our services? If so, please fill out the fields below. Someone will contact you in regards to your request and we wi

First name: Last name:

E-mail:

Phone #:

Address/Office:

What is your platform: PC MAC

What is your status. Please check one:
Freshman Sophomore Junior Senior Faculty Staff Adjunct Faculty

What type of assistance do you need? Please be as descriptive as possible.

Is there a particular time/day that works best for us to contact you?
Yes No

If so, when?

Additional Comments:

Thank you for completing the CTL Request Form. If you have any questions, please call
Keeta Martin, ext. 6294 or Candace Bonnett, ext. 5750.