Training Request Form

Requestor's Name:*

Full Name

Instructor Information

Instructor's Name:*

Full Name

Instructor's Email:*

Instructor's Phone Number:*

Course Information

Course Title:*

Course Description to be Displayed to the User:*

Type of Course:*

eLearning
In-Person Training
Virtual Training

Course Size Limit:

For In-Person or Virtual Training

Waitlist:

(Only available for In-Person or Virtual Training)

Yes
No

Is the course:*

Required
Recommended
Available in Learning Library

Make Course Available to (select all that apply):*

*(if you have a Specific Group, please use the "Course File" section below to upload a spreadsheet containing their names, emails, and EUID's)

Course Category:*

Business Processes
Compliance
Leadership Development
Human Resources
Other

Enter Course Category*

Provide Learner with Certificate upon Completion of the Course?*

Yes
No

Require a Passing Score for the Course?*

Yes
No

Passing Score:*

Allow Multiple Attempts?*

Yes
No

Max Number of Allowable Attempts:*

Setup Course for Re-enrollment?*

(Course can be scheduled to re-enroll users within a specific timeframe. i.e. HIPAA course reassigned after 365 days of users completion date)

Yes
No

Course Re-enrollment within ____ days:

Please enter a number less than or equal to 365.

Session Date(s) & Details:

Session Details:*

Date:	Start Time:	End Time:	Location:	Virtual Link:	Access Code:	Password (If applicable):

Course Enrollment Deadline or Course Completion Due Date:

(Users will not be able to enroll in In-Person or Virtual Training after 12:00 pm from selected date)

Date:*

Course Reports

Schedule Automatic Reporting Regarding Training Status?*

Yes
No

Send Automatic Reports:

Email:

Who would you like the report sent to:

Course Files

Files:

Please attach any course material, handouts, or instructions to be made available to the user upon enrolling in the course.

Drop files here or

Accepted file types: gif, jpg, jpeg, png, pdf, doc, docx, ppt, pptx, xlsx, , Max. file size: 22 MB.

Please Email Additional File Types to LearnHSC@unthsc.edu

Additional Course Information

Please enter any additional details regarding the course in the text box below.

Consent*

I acknowledge that I have reviewed the materials being provided and they comply with the State of Texas and UNT System policies on accessibility. I also confirm that none of these materials are subject to copyrights that prevent them from being reproduced for HSC’s purposes.

Questions:

Please contact the Office of Integrity & Awareness at LearnHSC@unthsc.edu with any questions.

Administrative

Training Request Form