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FOR FACULTY AND STAFF USE ONLY

Please complete this form to request the enrollment of external students or students who are not registered in MySJSU from Moss Landing Marine Laboratories in a course in Canvas. Only the instructor(s) of the course and/or the department Chair may authorize this request. Fields marked with (*) are required.

I. Instructor Information

First Name (*)

Last Name (*)

Nine Digit SJSU ID (*)

Phone Number (*)

Email Address (*)

Department/College (*):

Department/Chair (*):

Rationale for Request*:
(Please describe the circumstance/s and purpose for allowing Canvas access to users who are not registered in the course.)

II. Course Information

Semester (*)
(e.g. Fall 2013)

Course Code/Course Name (*)
(e.g. ECON-100, Introduction to Economics)

Section (*)

III. Student Information

Please upload a .csv (MS Excel) or .doc/.docx (MS Word) file with the following information for each student:
First Name, Last Name, Email Address, SJSU ID (if applicable).