Please fill out the following information and return to your advisor.

This information will NEVER be

used. It will be safely locked in your file in the office for future reference should you need to
remember your user ID and password.

ACT WEB ACCOUNT for

User ID

Password

Please fill out the following information and return to your advisor. This information will NEVER be
used. It will be safely locked in your file in the office for future reference should you need to
remember your user ID and password.

ACT WEB ACCOUNT for

User ID
Password

Please fill out the following information and return to your advisor. This information will NEVER be
used. It will be safely locked in your file in the office for future reference should you need to
remember your user ID and password.

ACT WEB ACCOUNT for

User ID
Password

Please fill out the following information and return to your advisor. This information will NEVER be
used. It will be safely locked in your file in the office for future reference should you need to
remember your user ID and password.

ACT WEB ACCOUNT for

User ID
Password

Please fill out the following information and return to your advisor. This information will NEVER be
used. It will be safely locked in your file in the office for future reference should you need to
remember your user ID and password.

ACT WEB ACCOUNT for

User ID
Password