Technical Problem Report Form

Contact Information
NOTE: Many login problems can be easily resolved by simply resetting your MyPortal password. Please try to reset your password first. If the process still does not help, then fill out the form below. We will review the details and contact you. Click here to reset your password
What is your full name? (Required)
If you are a Foothill or De Anza student, please enter your 8-digit campuswide ID:
What is your e-mail address? (Required)	(Example: name@email.com, double-check your entry for correctness)
In case we need to talk to you, what is your phone number? (Required)	(Please include area code, example: 408-555-1234)
Problem Details
What is the date and time you experienced this problem? (Required)	(Example: 4/1/2010, 9:00AM)
Your Institution:	Foothill College De Anza College Central Services
Your Location:	On Campus Off Campus
Are you an international student?	Yes No
Your Internet Connection Type:	Dial-Up Broadband (DSL, Cable, etc...)
Your Operating System and Version:	Microsoft Windows Mac OSX Mac OS 9 Linux Variants UNIX Variants Other Version: (Examples: Vista, XP, 2000, 10.5, 10.6)
Your Web Browser and Version:	Internet Explorer Firefox Safari Netscape/Mozilla Opera Other Version: (Examples: Internet Explorer 7.0, Firefox 3.5)
You are using MyPortal to:	Apply for Admission Register for Courses DegreeWorks Other
Quarter:	Quarter: Fall Winter Spring Summer
Problem Description:	Account Not Found Account Locked Student Credentials Failed Employee Credentials Failed Other
List applications running at the time the problem occurred: (Example: Anti-virus, firewall, pop-up blocker, any browser add-ons)
Enter the error messages received:
Enter a detailed description of the problem:
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