RSPH Professional Advancement & Student Experience (PASE) Center Platforms Support Request Form

This request form is for current RSPH students and alumni who are requesting new accounts or seeking to deactivate PASE Platform accounts (12twenty, APE Portal, and/or VMOCK). Additionally, this form may be used to request technical support for PASE platforms. Please allow up to 1-2 business days for review and follow-up, depending on the volume of requests.

ALUMNI PLEASE READ!

Although it is not required for alumni access to the systems, we recommend that alumni sign up for an alumni email address (@alumni.emory.edu) and use it for accessing RSPH PASE platforms. To register for an alumni email, please copy this link:

https://securelb.imodules.com/s/1705/21/interior.aspx?sid=1705&gid=3&pgid=8

First Name (Given name on file with Emory. Please DO NOT provide nicknames or preferred names):*

Given name on file with Emory. Please DO NOT provide nicknames or preferred names.

Last Name:*

Status:*

Are you a current RSPH student or alumnus?

Select

Emory NETID:*

Emory Email:*

Please enter the long version of your Emory email.

Email*

Your Emory alumni or personal email.

RSPH Department:*

Department/Program currently enrolled in or enrolled in while attending the RSPH.

Select

Expected Graduation Year or Graduation Year:*

Select the year you are expected to graduate or the year you graduated from the RSPH.

Select

Country of Citizenship:*

Please type in your country of citizenship.

Platform(s) your request is related to (Check all that apply):*

12Twenty

VMOCK

APE/Practicum Portal (Currently Students Only)

Student Request Category:*

Select

Alumni Request Category:*

Select the type of request you are submitting.

To request removal from emails from 12twenty, please be aware that your account will be deactivated, meaning you will be unable to apply to jobs, register for events, or view research tools, among other functions. You will select "Deactivate 12twenty Access" as your Request Category. If at any time in the future you wish to regain access to the resources and tools invested in by the RSPH for students and alumni, you will need to submit a request via this form to have your account reactivated.

Select

Graduate Outcome:*

We need to ensure we have a graduate outcomes on file for you before we can deactivate your account particularly if you are a recent graduate. As a reminder, this data is important for the value of your degree, maintaining the school's accreditation, and continued investment in our students and alumni.

Select

Employer Name:*

Please do not abbreviate the name of your employer. This helps us to ensure the organization is represented appropriately and the we have clean/accurate data.

Job Title:*

Please do not abbreviate your title.

Industry:*

Select or enter value

Base Salary:

This information is provided in aggregate form only and no one will be able to see your salary once entered into 12twenty except for an admin.

University:*

Please include full name of the university and not an acronym.

Degree Level:

Select or enter value

Degree Earning:*

Examples: DrPh, MD, DO, MBA, NP, etc.

Field of Study:*

Examples: Public Health, Medicine, Business, Law, Nursing, Epidemiology, etc.

Graduate Outcomes Note!

If you are a 2023 or 2024 graduate of the RSPH, we are unable to deactivate your 12twenty account until you report an outcomes status other than seeking employment/education.

Please provide a summary of your request: (Remember details are important/helpful for resolving the issue and providing a solution so the more details the better.)*

Please briefly describe the reason for your request.

Please upload a screenshot of any error messages or other screens:

Please upload a screenshot of any error messages or other screens helpful for providing technical support. Please DO NOT crop out the browser link.

Drag and drop files here or

Form Date Field

Send me a copy of my responses

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