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Request ANGEL SOM Course

School of Medicine ANGEL Course Request Form

Instructor Information
First Name:
Last Name:
Email Address:
Phone
Course Information
Course Title:
Course Number: (e.g. ICM801)
Course Start Date: (MM/DD/YYYY)
Line Number(s):
Comments and special instructions
If your course falls outside of the regualr university schedule, please indicate a preferred start date and end date in the comments section below:

Questions about completing this form? Please contact:

Nellie Modaress
Educational Technology Liaison to the School of Medicine
913-588-7341
nmodares@kumc.edu

     Last modified: Sep 12, 2012