moodle online support site request

Requester details
First Name / Click here to enter text. / Last Name / Click here to enter text. /
Job Title / Click here to enter text. / Phone/Ext / Click here to enter text. /
Email Address / Click here to enter text. /
Head Teacher/Manager Details
First Name / Click here to enter text. / Last Name / Click here to enter text. /
Email Address / Click here to enter text. /
Course Details
Qualification Name / Click here to enter text. / National Code / Click here to enter text. /
Product Code / Click here to enter text. / CalOcc Code / Click here to enter text. /
Faculty / Click here to enter text. / Teaching Section / Click here to enter text. /
Campus / Click here to enter text. /
VET Fee Help / Yes ☐No ☐
Course Start Date / Click here to enter text. / Course End Date / Click here to enter text.
Would you like students to access this page via a link in the Learner Portal?
Note: this will mean that students will be automatically enrolled in the course page when their enrolment is finalised. * / Yes ☐ No ☐
Would you like to provide learning and assessment materials for the student to access online? / Yes ☐ No ☐
Is Moodle training required for teachers involved in this course? / Yes ☐ No ☐
Teacher/Assessor/Coordinator Details
Please Enter a role / Click here to enter text. /
First Name / Click here to enter text / Last Name / Click here to enter text /
Phone / Click here to enter text / Email address / Click here to enter text /
Office Hours / Click here to enter text /
Any other information to be included (e.g. role, units taught)
Click here to enter text /
Teacher/Assessor/Coordinator Details
Please enter a role / Click here to enter text. /
First Name / Click here to enter text / Last Name / Click here to enter text /
Phone / Click here to enter text / Email address / Click here to enter text /
Office Hours / Click here to enter text /
Any other information to be included (e.g. role, units taught)
Click here to enter text /
Teacher/Assessor/Coordinator Details
Please Select a role / Click here to enter text. /
First Name / Click here to enter text / Last Name / Click here to enter text /
Phone / Click here to enter text / Email address / Click here to enter text /
Office Hours / Click here to enter text /
Any other information to be included (e.g. role, units taught)
Click here to enter text /
Student Information
What textbooks do the students need to have? / Click here to enter text /
What PPE does the student need to have? / Click here to enter text /
What stationery does the student need to have? / Click here to enter text /
What other equipment does the student need to have? / Click here to enter text /
What course(s) can the student progress to on completion of this course? / Click here to enter text /
Is there any additional information you would like to provide? / Click here to enter text /
Attachments
Please attach the following documents/images when you forward this form
  • Course Learning and Assessment Plan (PDF Format)
  • Course Timetable (Optional)
  • Photo for each Teacher/Assessor/Coordinator (photo should be 100px x 90px in size)
  • Any additional documents to be included in the Moodle Online Support Site

Please email this form and attachments to

Filename: Moodle Online Support Site RequestDate Published: 20180124

Document Owner: Digital Learning ServicesPage 1 of 2

Printed copies of this document are not controlled. Please refer to for the current version