Bryan: Bookstore Building, Rm G212
Brenham: Classroom Building, Office 19
Virtual College of Texas
Please complete the following form. Make sure you complete all of the required fields.
* = Required fields
Section 1: Contact Information
Is this request for*:
Blinn ID (If you have one):
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
Are you a current Blinn Student? (Are you enrolled in Blinn College this semester or were you enrolled last 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.