Blackboard and VCCS Student Email Help Request Form
(information in red is required)
REQUESTOR INFORMATION
Full Name
Blackboard Username
(e.g. jtyler9999, jmt8)
EmplID
(e.g. 1234567)
Date Of Birth
(MM DD YYYY)
Daytime Phone Number
ext.
(please include area code)
Alternate Phone Number
ext.
(please include area code)
Email Address
(please provide the address which you most frequently check)
Provide Your Online ISP
(Internet Service Provider):
(Examples: AOL, Earthlink, Comcast, MSN)
Provide Browser Name and Version:
(Examples: Internet Explorer 6, Netscape 8, Firefox 1.5)
Description Of Problem:
Please provide as much information as possible: (for example, describe the error message you receive, indicate if you are experiencing technical problems, etc.).
With which product do you need assistance?
Blackboard
VCCS Student e-mail