Course Request Form:
AMS Support Office (Campus zip 5604) Call 335-6518 with questions

Term (please indicate):


Course prefix:
Course number:
Is course cross listed/conjoined?
Course title:
Day(s) :
First Class Meeting Date:
Last Class Meeting Date:
Starting Time:
 :
Ending Time:
 :


Primary Origination Site:
Credit hours:
Requester Name:
Requester Phone:
Requester Email:
Instructor Name:
Instructor Phone:
Instructor Email:
Contact Person:
Contact Phone:
Contact Email:
Will course be videostreamed?
Financial Arrangements:
Remarks:
 








 

 
For the origination site and each destination site, please provide the number of students.
Sites
Please Check All Sites Involved		 # of students Campus to which student
FTE's are assigned		 Schedule Line Number Section Footnote Site Code
Pullman
Spokane
Tri-Cities
Vancouver
Aberdeen
Centralia
College of Nursing Spokane
College of Nursing Yakima
Colville
Everett

Goldendale
Longview
Port Hadlock
Puyallup
Renton
Skagit Valley
University of Idaho
Videostreaming
Walla Walla
Wenatchee
Yakima
Other Sites


The online CRF should be submitted to Academic Media Services upon completion by the department. Academic Media Services will review the form, and then send it to be electronically signed by the appropriate person. It should then be electronically sent back to Academic Media Services.

Academic Media Services will next distribute the completed form to the designated person at each site for acceptance/changes and electronic signature.