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New E-Learning Request, form #1

Use this form to submit a new e-learning request to CED before you begin developing or purchasing any materials. A CED team member will follow up with you. If you would like help completing this form, contact Liz du Plessis (eac506@health.missouri.edu)
2. Approvals: Has this education plan been approved by your leadership? *This question is required.
Please obtain approval before submitting this form.
3. How will the audience access the education? Select all that apply. *This question is required.
4. Why is this education needed? Select all that apply. *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
7. Requester contact information *This question is required.
To be completed by CED

Dates
Form 1 received:
Followed-up with requester:
Presented at meeting:
 
Pre-approvals
Names & dates:

Notes
Instructional Designer: 
Tech Team: 
Clinical Education Team: