Please fill the survey out in order to receive a username and password. The username and password will be used to log into your Collins e-mail account and to access your online course work on Moodle.
First Name (Please list First name on record at Collins Career Technical Center)
Last Name (Please list last name on record at Collins Career Technical Center)
What program are you currently in?
Health Information Systems
Registered Nurse (RN)
licensed Practical Nurse 101 (LPN)
licensed Practical Nurse 102 (LPN)
licensed Practical Nurse 103 (LPN)
licensed Practical Nurse 105 (LPN)
Medical Administrative Assistant
Patient Care Tech (PCT)
T & I
Diagnostic Medical Sonography (Ultra Sound/DMS)
Please create a password that has at least 8 characters and does not contain symbols.
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This form was created inside of Collins Career Technical Center.
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