Indicates required field Role(s) - select all that apply Instructor Advisor Teaching Assistant Field Advisor Grading Proxy Effective Term - None -FallSpringSummer Effective Year First Name Middle Name/Initial Last Name To be entered if instructor already exists EmplID NetID (e.g., abc123) Primary Org/Dept? If this is a new instructor Birthdate Home Address Home Phone School/Dept in which this instructor will teach: School - None -College of Arts and SciencesSchool of EngineeringSchool of MedicineSchool of ManagementSchool of NursingSchool of LawSchool of Applied Social SciencesSchool of Dental MedicineCleve Clinic Lerner Coll of MedEngineering & ManagementApplied Soc Sci & Management Acad Org/Dept? Additional information may be required. If this is regarding an existing instructor Add or Inactivate Add Inactivate, instructor no longer with the department/university School - None -College of Arts and SciencesSchool of EngineeringSchool of MedicineSchool of ManagementSchool of NursingSchool of LawSchool of Applied Social SciencesSchool of Dental MedicineCleve Clinic Lerner Coll of MedEngineering & ManagementApplied Soc Sci & Management Acad Org/Dept? Requestor Name Requestor Phone Number Requestor Email For questions regarding this form, please contact the University Registrar's Office at courses@case.edu or 216.368.4310. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Reset Leave this field blank
