Register for a New Account

Fill out the form below in order to create a new account on this system. Fields marked with * are required.

Note: To complete the registration process and ACTIVATE your account, click on the automated email you receive after submitting the form below.

First Name *

Last Name *

Name Pronunciation

Email Address *

Standing *

Student, Staff, or Faculty ID *

Major (write "undecided" if unsure) *

International Student *

English Academic Preparation (EAP) student? *

First or Home Language *

Password

Passwords must be ten or more characters long.

Password *

Re-enter Password *

Send me an email when my appointments are made, modified or canceled.

Send me an email with center announcements or other mass mailings.

Send me an email to remind me of my upcoming appointments.

Include iCal links with appointment confirmation messages.

Open appointments in a new popup window (instead of in a modal within the same browser tab).

In order to help prevent fake or automated registrations on this system, please complete the captcha form below.