Course Request Form Maymester, Summer I, Summer II and Fall 2026

Course Request Form

This form is used to submit requests for the creation of courses in Banner. It allows the eLearning & Instructional Innovation Center to collect all required information to accurately process course setup requests and ensure alignment with institutional systems.Please provide complete and accurate details to help facilitate timely processing and avoid delays.
Start by selecting the Department*
Department Information:*
eLearning Courses email:
example@example.com
Department Chair Name:
Department Chair Email:
Department Chair Name*:
Department Chair Email*:
Instructional Assistant Name:
Instructional Assistant Email:
Instructional Assistant Phone Number:
Instructional Assistant Name*:
Instructional Assistant Email*:
Instructional Assistant Phone Number*:
Requested by:*

First NameLast Name
Requestor Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

IMPORTANT: Please click Review Answers below to verify the information you have entered. After reviewing your information, you can click the Back to Form button to make any edits. Then, click the Submit button.

Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty: