Instructor Add/Remove Request Form
Submit requests to add or remove instructors for courses, programs, or departments.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Position or Role
*
Department or Unit
*
Type of Request
*
Add Instructor
Remove Instructor
Course or Program Name
*
Course or Program Code (if applicable)
Instructor(s) Involved
*
Effective Date for Addition or Removal
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Adding or Removing Instructor(s)
*
Supporting Documents (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Submit Request
Should be Empty: