Account Initialization Request Form

With so many options, picking a major can be difficult. Let us help you find yours!

Use this form to request a new Regent account initialization email.

If the email address you specify in this form is different from the one we have on file, someone will contact you by phone to verify your identity before sending a new initialization email.

* denotes a required field.

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Date of Birth*
School*
Email Address*
Is this email different from the address we currently have on file?*
- Yes
- No
- Unsure
Phone Number*
Best time to reach you*
Questions or comments