SPECIAL APPLICATION PASSWORD and ACCESS CODE REQUEST

This form is only for students who have arranged a
SPECIAL COURSE OF STUDY
with SLBC


It is now required that students use proper letter-case and proper spacing in all submissions
to the college.  Use of all upper-case or all lower-case letters is not allowed.  The only
exception is in the rare case when it may be required.  Failure to use proper
letter-case will result in the form or test being disallowed.  All disallowed
forms or tests must be resubmitted by the student and the new sub-
mission
must be marked as "Amended".  This requirement includes
proper use of letter-case and spacing when submitting personal
names on all forms, tests,
and all other correspondence
sent from the student to the college.

*Is this an Original or Amended form:
Original: Amended:
*Your full name:Please enter your full name.  Your given name first, then your middle initial if you used it on your Application.  Last of all give your family name.
*Email:
*Verify Email:
*I verify that I have arranged a Special Course of Study with SLBC:
Yes.
*Confirmation Code (Enter code EXACTLY as it was given to you.)

Proper letter-case and spacing of words is required in all correspondence sent to the college.

*Proper Letter-case and Spacing Verification:
Yes.

Verify Authentication Code: