If you have any questions about this application, please contact the Help Desk: helpdesk@pierce.ctc.edu or 253-964-6373.

All items are required unless otherwise noted.

Account Type


Personal Information

Please provide your official first and last names.

First Name:  
Last Name:  
MI:  
SID (Optional):  

Work Information

Note: For office room number and work phone number, please provide the Division Assistant or Department information if one was not assigned.

College Site Location:    
Department/Division:    
Title:    
Building:    
Office/Room:    
Work Phone:  
Fax (Optional):

Employee Information

Employment Status:    
Employee Type:    
If hourly, specify:
If other, please specify:

Acceptance Signature

I hereby request a Pierce College District Network account for purposes of accessing the District network, e-mail, and the internet.
By checking the box below, I am verifying I have read the Pierce College District and K-20 Acceptable Use Policies, procedures and guidelines, and the Executive Ethics Board guidelines for computer related use. I agree to abide by their provisions.

I Accept

Supervisor of Record/Area Administrator Name:

   

All accounts require acceptance of terms and supervisor's name.