Moodle Course Shell Request
Your Name *
Your answer
Your Region 10 Email Address *
Your answer
Your Region 10 Phone # *
Your answer
Course Name *
Name can be edited before publish date.
Your answer
Tentative Course Description *
Description can be edited before publish date.
Your answer
# of CPEs to be issued *
Teacher(s)/Editor(s) of the Course *
Your answer
Would you like assistance from an Instructional Designer?
Special Notes
Your answer
Course Review and Publish Requests
The Course Review and Publish Request form will have additional information regarding enrollment keys, free or for a fee, co-ops allowed, etc.
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