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First Name: MI

Last Name:

College or University Name:

Street Address or P.O. Box:

Second address line (if needed)

City: State: Alabama Alaska APO AE APO AP Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC American Samoa Guam Puerto Rico Virgin Islands

Zip Code:

Work Phone Number: - -

Work e-mail address:

Does your college or university use a Local Area Network or Wide Area Network?    LAN     WAN

Do you serve military students as a targeted sector of your student body?   Yes    No

If so, is your college or university a SOC Network College?    Yes    No

Do you serve corporate students who have attended ACE-evaluated professional training as a targeted sector of your student body?   Yes    No

Does your college or university award credit for national college credit-by-examination programs?   Yes No

Does your college or university award credit for professional certifications?   Yes No

Does your college or university award credit for adult experiential learning assessment?   Yes No

Approximately how many courses are in your current college catalog?

Approximately how many undergraduate certificates and degrees does your college offer?:

Approximately how many graduate certificates and degrees does your college offer?:

Approximately how many satellite campuses does your college or university host?:

Are degree plans to be created at the main campus only?   Yes No
               If no, how many of the satellite campuses will also process degree plans and need system support?:

Check here if you are interested in a proposal for an AutoDP system for your college or university

Check here if you are interested in a proposal for an AutoDP system for your college or university, along with the companion software - the wcAutoDP web interface

If you would like for us design the system to export data from the AutoDP system for importing into your SMS, please let us know.  The text box below provides space for you to describe the data you would like transmitted.

Describe the information you want exported:

How to submit this form:  When you press the submit button below, your computer will transmit the information to us and present you with a screen that thanks you submitting the request. 

If this does not does not submit, please print it and fax it to us - your responses should print as you see it on the screen:  Our fax number is (850) 478-3664.  If you are having difficulty with this or have any questions, please contact us via e-mail.