Class Website Request Form

Class Website Request Form

Please fill in this form to help us set up your class website
Course Number *
ie. Ge 111
Instructor
Type of Website Required *
Password Required? *
Names of users that will need access to edit the website *
Will you need additional support?
Name *

First Name Last Name
I am a:
If "Other", please describe below
Describe Other
Phone Number

Area Code Phone Number
Email *
example@example.com
Website Contact
Lisa Christiansen: lisac@gps.caltech.edu

Please print a copy for your records , then click the "Submit" button below to submit this form electronically.
Alternately, you can use campus mail to send the form to:

Lisa Christiansen
MC 100-23
Should be Empty: