Letter of Agreement
Counseling 105

Complete this form if you have access to the Internet and an email address. Please answer questions 1 and 2 only if you are officially enrolled in Counseling 105 at Coastline Community College. By completing this letter of agreement, your instructor will have another avenue to communicate with her students. Students have the option of completing online activities where they may participate in group activities and communicate with shared email addresses.

LAST NAME:

 (e.g. Smith)

FIRST NAME:

 (e.g. John)

STUDENT ID NUMBER: 

 (e.g. 12345678)

E-MAIL:

 (e.g. student@aol.com)

PHONE:

 (e.g. (714) 241-6216)

1. Can your instructor and the Coastline's Distance Learning Department use the E-mail address that you have provided to send you course information, instructor messages and assignment scores?
Yes No
If no, is there another E-mail address you can provide?
alternate E-mail address

Note: Students are required to provide their own E-mail addresses. If this is not possible, please contact your instructor on how you intend to submit course work and receive feedback on assignments and instructor messages at njenkins@coastline.edu

If an E-mail address is restricted to screen unwanted mail, the restriction may need to be lifted in order to receive messages from the instructor and the Distance Learning Department at Coastline Community College.

2. I want to participate in online group activities with other members of the course. It is okay for me to share my email address with the course members.
Yes No