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Special Populations Form

CGTC Special Populations Form

In order to best serve students enrolled at Central Georgia Technical College (CGTC), the College needs to know if you meet any of the category definitions included in this survey. The information you provide will be kept strictly confidential and will be used to assist CGTC in delivering better services to students. Please note that while this information is gathered to better serve your individual needs, it is also used for federal reporting purposes.

1. Student Information

First Name
Middle Initial
Last Name
Student ID Number
Phone Number
Email Address
Address

2. Program of Study

Please select your major from the following list.

Please type your major if not listed.

3. Where are you taking classes?

4. In what semester and year are you taking classes?

Semester

Year