Request edit access
Moodle New User Request Form
This form is for authorized users only. Authorized users include: registrars, administrators, and faculty with permission. All others must request user accounts through their school's respective registrar.
Please enter the first/given name for the account requested.
Please enter the last name/family name for the account requested.
Please enter the email address for the account requested. Please use the account user's official email (e.g.
Please enter the school or of primary affiliation.
GTU > CARe
GTU > CDS
GTU > CIS
GTU > CJS
GTU > CSS
GTU > CTNS
PSR > CGSB
PSR > CLGS
PSR > TEL
Degree or Certificate Program
Please select the degree or certificate program below.
Certificate or Special
Other (requires e-mail to firstname.lastname@example.org)
Is the user Temporary?
Please select the appropriate status (A= Active, T=Temporary)
If temporary, please enter the account end date.
If this request for a temporary user account, please enter the ending date (for example, a student taking a one-week course only).
Please enter the location of the student in city, state format
Your name? (authorized users only)
Please enter your name and contact information if we have any questions regarding this request.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service