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The University of North Carolina at Chapel Hill
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Course Registration Request
Course Registration Request
Program Manager Name
(Required)
First
Last
Email
(Required)
Course Title
(Required)
Cost Code
If cost code has not yet been created by Registration, one will be created upon submission of this form.
Location
(Required)
For in-person courses, enter the name of the event venue; for online courses, enter "Online" or "N/A".
Enter Address Location
Online
N/A
Other
Format
(Required)
In-Person
Online
Hybrid
On-Demand
Certification
Office Hours
Credit Only
Service Agreement
Address
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Start Date
(Required)
Month
Day
Year
End Date
(Required)
Month
Day
Year
Start Time
Hours
:
Minutes
AM
PM
AM/PM
EndTime
Hours
:
Minutes
AM
PM
AM/PM
Additional Dates/Times
If multiple sessions, please list additional dates and start/end times
Zoom Access Type
If the course format is online or hybrid, select how registrants will receive the link to access the Zoom Meeting/Webinar room, which will inform what language is included in their Learning Stream confirmation.
Registrant will access Zoom directly; link will be provided in the Learning Stream confirmation
Registrant will be required to register in Zoom in order to receive the link; link to register will be provided in the Learning Stream confirmation
Registrant will receive the Zoom link at a later date from the PM; Zoom information will not be provided in the Learning Stream confirmation
Zoom Details
If the course format is online or hybrid, and the direct Zoom URL or Zoom registration link should be included in the confirmation email, copy and paste the relevant details from your Zoom meeting/webinar set-up here, including meeting/webinar URL/Zoom registration link, meeting/webinar ID, and password.
Canvas
Yes, the course will use Canvas; standard language for setting up/accessing Canvas, including links to the login page and supporting documentation, will be provided in the Learning Stream confirmation
Yes, the course will use Canvas; information on setting up/accessing Canvas will be sent at a later date by the PM and should not be provided in the Learning Stream confirmation
No, the course will not use Canvas
Additional Canvas Details
Any additional Canvas details to include in the Learning Stream confirmation.
On-Demand URL
For on-demand items, the direct link to the recording provided by IT.
Application
(Required)
Is this course application-based?
Yes
No
Application Deadline Date
If the course is application-based, what is the application deadline date?
Month
Day
Year
Application Notification Date
If the course is application-based, what is the date by which applicants will be notified of their status?
Month
Day
Year
Maximum Participant Capacity
(Required)
The default maximum participant capacity for in-person courses is the classroom capacity, and for online courses is 275 for Zoom Meetings/475 for Zoom Webinars.
Registration Fee ($)
(Required)
Lead Faculty Name
(Required)
First
Last
Additional Registration/Application Questions
Additional questions to be included on the registration/application form.
Additional Notes/Information
Any additional notes or information regarding the set-up of this course.
Name
This field is for validation purposes and should be left unchanged.