Custom Program Request

Complete this form to request a custom program through CSUCI's Extended University. Custom programs may be non-credit certificate programs, professional development, or short-term learning experiences. Questions: Please contact ext@csuci.edu.

Name of Program

This may be a single course, a multi-course program, or a workshop

Program Description

Provide a description of the program and any additional information.

Will students get University credit for this program?

Date and Frequency

Do you have a date for this program in mind?

Number of Courses or Workshops

How many courses or workshop are included?

Estimated Enrollment Per Cohort

Provide range

Program Development

Is this program already developed or do you need development support?

Faculty

Do you have faculty identified to teach this program or will you be hiring someone new?

Supplies or Materials

Are additional supplies or materials needed for this program?

Marketing and Recruitment

Do you have a cohort of participants or will you have EU market and recruit this program

Participants

Provide some more details about who the potential participants for this program will be or ideas about industry partners that we may contact.

Finances

Do you have external funding to help cover costs in this program? If so, please describe.

Any Attachments

Attach file

Drop files here

Frequency

How often would you like to offer this program?

Additional Comments

Additional Information

Add

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