Request My Account

Account Information:

Email Address *

We will email you your login name within one business day

Email Address Confirmation *

Phone Number

Indicate a phone number for follow-up questions.

Temporary Password (at least 6 characters) *

Remember this password! - you will use it shortly to activate your account.

Confirm Password *

Identification

First Name *

Last Name *

Other Names Used

Provide former name(s), if any

Student ID (A Number)

It is OK if you don't know your student ID.
PLEASE DO NOT enter your Social Security Number! If you don't know your "A" Number, just leave this blank.

Student Verification

Answer the following questions to the best of your ability so that we might verify your identity

Date of birth *

Last four digits of Social Security number *

If you do not have a Social Security number, enter NA.

Indicate when you attended Evergreen. *

General time frame is fine, such as "fall 1983 to spring 1985"

Name a program or course you took while at Evergreen *

Perfect accuracy is not required

Instructor of this program/course *

I hereby certify that all of the above information is correct and that I am the (former) student who is requesting the account. *