User Application

Applicant Information

Last Name

First Name

Middle Name

Work Phone

Country

City

Area

Number

Extension

Work Email

Academic Institution

Primary Institution

Additional Academic Institution

Additional Institutions

None Selected

Supervisor Information

Last Name

First Name

Middle Name

Work Phone

Country

City

Area

Number

Extension

Supervisor Email

Supervisor Title

Duties Performed

1. Will you be submitting final grades for students?

Yes No

2. Does your school have a partnered contract with the United States Naval Community College (USNCC)?

3. Will you be updating tuition rates for your institution?

Yes No

4. Will you be updating the course catalog for your institution?

Yes No

5. Will you require access to TA usage reports?

Yes No

6. Will you be posting degree completions for your school?

Yes No

7. Will you be requesting physical access to a military installation?

Yes No

I Certify the Following:

The supervisor added to this request is indeed your immediate supervisor and false documentation will result in denial of future request.

Supervisor confirmation of work duties selected and verification of employment is required within 7 days of outreach from staff.

The system will lock me out for inactivity after 30 days (DOD Regulation). It is recommended that I set a reminder to log-in every 30 days to avoid log-in issues.

Federal law prohibits the sharing of username and passwords used to access government information systems.

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