You must be the instructor of record to make this request.

*Field is required

Requestor

This must be your Chemeketa email address.

Person Being Granted Access

List any additional users in the Notes field.

Term

Course Details

Specify which type of access is needed.

Course Information

ex.: 12345 or tbishop2.ba101.dev01
enter any additional CRNs or Course Numbers in the Notes field

Notes

Please check your email for a confirmation. Form will be sent to you, and the System Administrator.