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Course Request Form

To request a course, please complete and submit the following course request form.

This form should be used for Non-timetable courses or to request a course space earlier than our automated process creates them. All Timetable courses are created by an automated process shortly after students begin to register for classes.

Be sure to complete and submit a separate request for each course that you need.

You will receive an email notification when your course is available.

If you have any questions or need assistance with completing this form, please contact the UW-Madison Campus Administrator.


Course Request Form

Course Contact Information

Name

*

Telephone number


Include area code if other than 608.

Email address

*

NetID

*
To activate your NetID or reset your NetID password, go to http://helpdesk.wisc.edu and click on "NetID Self Help"

Additional instructor's NetID


Course Information

School/College

Department name

Department number (if available)

Course title for your course space

*

Course purpose
Course start date
Course end date

Participants

Number of participants

Student participants will first need access to the course space in the following month/year:

There are several ways in which participants may be given access to your course. In order to determine the most feasible method it is helpful to understand a little bit about the participants.  Please tell us:

1. Roughly what % of the participants/learners have an affiliation with UW Madison?   

2. Will you be able to identify the entire population of participants, by name, before participant access is needed?

Yes

No, but I will know the following about the participants

More information
(please use this field for special instructions or comments)