Center for Academic Technology Solutions

Requesting New Organization Shell

Organization's Information


*Required Fields

* Organization's Name


* Duration


*Accessibility


*Nature of Organization


*Nature of Membership



Leader's Information

The Organization's Leader * Required Fields

* First Name


*Last Name


*Phone Number
( ) - *ext :
* Email Address




Administrator's Information

Administrator with Rights to Enroll Users into the Organization
*leave blank if same as Leader

First Name


Last Name


Phone Number
( ) - *ext :

Email Address




Additional Comments