University Department Course Request Form

I would like an Angel Coursesite to facilitate training/instruction for my department or another University department.

Instructor Information
First Name:
Last Name:
Email Address:
Phone/Extension:

Course Information
Course Title:
Start Date
End Date: :
Content:	If content from a previous coursesite is needed, please specify the course title and when it was last taught.
Needed Assistance
	I don't need any assistance at this time. I will create and edit my own content. I need assistance creating a new coursesite.
Comments and Special Instructions Use the comments section below to list additional instructors or provide any other special instructions for this coursesite.

For questions about completing this form, please contact:

Grant James
Instructional Technology Support Specialist
913-588-7130
gjames@kumc.edu