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Online Course Support Request Form

Your Contact Information:

First Name:

Last Name:

Email:

Area Code: Telephone Number:

 

Your Course Information:

Course Title:

Course and Section Number (if known):

Professor:

Please provide all of the following information so that we can troubleshoot your issue:

GothicNet ID:
Last 4 digits of your Social Security Number:

Birth Month Birth Date Birth Year


Your Computer Information:


Do you use a Macintosh computer?

Yes
No

I Don't Know

Which web browser do you use?

Internet Explorer (please indicate version):

Mozilla Firefox (please indicate version):

Other (Please indicate)

I Don't Know


Brief Description of the Problem (please include the wording
of any
error messages you
have received):

 

Please Note: You will receive an automated response email to the email address you've provided. If you do not receive an auto-response, be sure to check your Spam/Bulk Mail folder. Add dlsupport@njcu.edu to your Address Book so our response reaches your Inbox.

 

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