JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
R-CCC Password Reset Request Form
The password reset is not yet an automated process. This request could take up to 5 days to complete. If you need faster access, call the DL Director at 252-862-1242 or email them at online@roanokechowan.edu
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What password needs to be reset?
Moodle site
Waves Email
Other:
Clear selection
User Name
Example: rcstudent1234
Your answer
First Name
*
Your answer
Middle Name
*
Your answer
Last Name
*
Your answer
Date of Birth
*
For example: 04011995
Your answer
Last 4 digits of your social security number
Your answer
R-CCC Student ID
*
7-digit ID number as found on your R-CCC Student ID Card,
registration statements, or Self-Service.
Your answer
Phone Number
*
Phone number must be valid and working so that we can alert you to your password being reset or to get further information to be able to reset your password.
Your answer
Alternate Email Address
This email will only be used to contact you so we can alert you to your password being reset or if we need to get further information to reset your password or to alert you to your password being reset.
Your answer
Additional Comments
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Roanoke-Chowan Community College.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report