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Blackboard Organization Creation Request

Pleasefill out, and print (Press CTRL+P) this form.  The submitter and approver must sign the form.  Send the signed form to the Assistance and Service Center (ASC) Help Desk, located at the lower level of the HS/HSL Building, Room LL06, 601 West Lombard Street, Baltimore, MD 21201 or fax to 410-706-4191.

Date Submitted:
Organization Name:«
Organization Description:«
Instructor's Name:
Instructor's Bb ID:
Submitter's Name (If different from Instructor):
Submitter's Phone Number:
Submitter's School/Department:
Submitter's Email:«
Submitter's Signature:
Approver's Name:
Approver's Signature:
(FOR OFFICE USE ONLY) Organization ID:
Fields marked with "«" are required.