Colleges That Change Lives

Changing Lives. One Student at a Time.

CTCL Form - For Counselors

Please fill out the form below to receive information from the CTCL colleges you select. The first part of the form is information about you. The last part is where you can select CTCL colleges from which to receive more information. You can select as many as you like. It is only necessary to fill this form out ONCE. When you have completed this form, press the REQUEST button at the bottom.

* indicates a required field

PERSONAL INFORMATION
^ Please enter your first name
^ Please enter your last name
^ Please enter your title
^ Please enter your high school or business name
^ Please enter your high school's CEEB code
^ Please enter your mailing address
^ Use this line for continuing your address if necessary
^ Please enter your city
^ Please select your state here
^ If you selected "other" above, please enter your other state here
^ Please enter your postal code here
^ Please enter a phone number where you can be reached
^ Please enter your fax number
^ Please enter your email address
PLEASE MAKE YOUR COLLEGE SELECTION(S) BELOW
Select any college or colleges below from which you would like to receive information. You can select as many as you like, but you only need to fill this form out ONCE.