Modular Building 2, Rm 208
Brenham: Classroom Building, Office 19
Virtual College of Texas
Please fill out this form completely. If you do not fill it out completely, your request will be delayed.
* = Required fields
Section 1: Contact Information
Is this request for*:
City, State, Zip*:
Valid Phone Number*:
Valid Email Address*:
Previous Distance Learning Experience:
1-3 Internet Courses
1-3 Blended Courses
More than 4 DE Courses
Section 2: Student Status
Note: If you are not a current Blinn student, you will need to become one before I can process your request.
Are you a current Blinn Student, meaning you have attended Blinn College during the current or previous semester?
Are you graduating this semester?
If yes, where are you graduating from?
Section 3: VCT Course
Course Requested (Example: PHIL 2306, not the title of the course):
Have you looked at the VCT web site for availability?
If yes, please list your preferred college: With regard to your preferred college, we will do our best to accommodate your request. However, in some cases, another college will be picked due to fees or previous experience.