Student Interest Form

Thanks for your interest in the TCCBE! Please note: This form registers you with the TCCBE – we will be in touch shortly after you click ‘submit’. It DOES NOT register you for a course. That comes later on…and gets handled through the Registrar’s Office (we’ll help you with that when the time comes). Click here to see a list of CBE projects that are currently available.

* Student Name:
* Email:
Telephone Number:
Student Number:
College:
Major(s):
Current Mailing Address:

Permanent Mailing Address & Telephone Number:

Academic Department and Course in which you want to do a project:

Projects Of Interest
1.
2.
3.
Prerequisites for participation (for full term or half term credit):
I have accumulated 10 full course equivalent university credits: Yes No 
I have a cumulative grade average of 75% or higher: Yes No 
Why do you want to do a Community-Based Education project?

How did you hear about the Community-Based Education program?

Any Comments/Additions?

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