Eagle Online Canvas - Student Support Request Form

Basic User Information:

First Name (Required)

Example "John"

Last Name (Required)

Example "Doe"

E-Mail Address (Required)

Example "W123456789@student.hccs.edu"

Phone Number (Required)

Example "713 555-5555"

Your "Eagle ID" (Required)

Example Eagle ID "W1234567" or "W123456789"

Student ID Number

Example "123456789"
( Must be 9 digits )


Online User's Course Information:

Your Course
(the one that is the problem) (Required)

Example "ENGL 1301"

The CRN Number (Required)
(for the course above)

Example "86999"

The type of Class (Required)    
  HCC Online Example - 100% of the class is online, except for proctored tests and labs
  Hybrid or Face to Face

Example - You must go on campus,
for a scheduled lecture with your instructor, at least once a week

Details of Online User's Problem:

Select a Summary (Required)

Attach file:

Select a file to attach if needed:

Describe Problem: