Human Services Course Request Form

Submit this form to request enrollment in Human Services and Community Leadership courses.

Name * First Last
Enter your EIU/Panther Email, or your request will not be processed. *
Enter your E# *
What is your academic rank? *
When do you plan to graduate? *
What is your minor? *
Human Services Program Administration Financial Literacy Early Childhood Program Administration Aging Studies Other
Is Human Services Program Administration (formerly FCS) your major? *
Yes No If not, what is your major?
Why are you requesting enrollment in this course?

(While Human Services thanks you for your interest in our course, enrollment is limited to students that need the class as an academic requirement.) *
Course Name:
(EXAMPLE: Life Span Human Development) *
Course Number:
(EXAMPLE: 1800) *
Must be 4 characters. Currently Entered: 0 characters.
Section Number:
(EXAMPLE: 001) *
Must be 3 characters. Currently Entered: 0 characters.
Course CRN number:
(EXAMPLE: 95482) *
Must be 5 characters. Currently Entered: 0 characters.
Semester/Year Course is Needed: *
Have you completed the required Prerequisite/s for this course?

If NO, please see below. *
If you completed the pre-requisite at another institution, please upload the syllabus from the prerequisite course(s)

Attach Files Attach Files
(if applicable)
Explain why you are requesting the class without completing the prerequisite.