SchoolEnrollment

Institutional Enrollment Screen

Welcome to the Honda Campus All-Star Challenge (HCASC) Institutional Enrollment page. By submitting this enrollment form, you, on behalf of your institution, hereby agree to the Rules Governing Participation (http://www.hcasc.com/rulesgovpart.asp). For that reason, only the President, Chancellor or a designated senior official with the authority to bind the institution is permitted to complete the enrollment. To facilitate the enrollment process we have included the data for the individual who last served as your Campus Coordinator. HCASC Headquarters reserves the right for final approval of Coordinator & Coach. If for any reason you have any questions, please call HCASC Headquarters (800-388-2272 x115).

Overall

Submitter Name

Submitter Title

Submitter Email

Submitter Phone

President or Chancellor Authorization

Please check the box if you have been directed by the President or Chancellor to complete this form on their behalf

Campus Coordinator Status

Coach Status

Fall Semester Start Date

Spring Semester Start Date

Campus Coordinator

Campus Coordinator Name

Campus Title

Campus Email

Campus Address Line 1 (Physical Address Needed - No P.O. Box)

Campus Address Line 2 (if needed)

Campus City

Campus State

Campus Zip

Office Phone

Cell Phone

Alternate Email

Is this person a 12-month employee?

If not, which months are they not expected to be on campus full-time?

Campus Coordinator Assistant (if applies)

Campus Coordinator Assistant First Name

Middle Name (or initial and period)

Last Name

Campus Email

Office Phone

Cell Phone

Alternate Email

Coach

Coach Name

Campus Title

Campus Email

Campus Address Line 1 (Physical Address Needed - No P.O. Box)

Campus Address Line 2 (if needed)

Campus City

Campus State

Campus Zip

Office Phone

Cell Phone

Alternate Email

Is this person a 12-month employee?

If not, which months are they not expected to be on campus full-time?

IT Department

IT Department First Name

Middle Name (or initial and period)

Last Name

Campus Email

Office Phone