Elluminate Live! Request Form

Fields marked with an asterisk (*) are required.
Requestor Information
Name*
Department*
Email*
Telephone Extension*
Session Information (Please tell us the details of your session)
Session Type	Academic session Meeting Course
Moderator	Self Nominee Name & Email address*
Training Required?	Yes No
Session Name*
Starting Date and Time	at :
Ending Date and Time	at :
Reoccurring	Yes No If reoccurring, list the additional days, dates, start times and end times. (Example: This course will meet every Monday from August 27, 2010 - December 5, 2010 from 1pm - 3pm.)
Record session	Yes No
Recording Format*	Elluminate Live! Link MP3 WMA All
Session Location	Session in your office Session in conference or a meeting room
	Please indicate where your session will be held and mention specific venue booked
Venue*
Number of Face to Face Participants*
Names/Email Addresses of Online Participants*
Additional Instructions


Please submit your request at least 7 working days prior to the start of your session. For questions about completing this form, please contact: Ms. Melaine D’Cruze Assistant Manager, eLearning Phone: 3634 7611 - 14, Ext 3912 Email: melaine.dcruze@aku.edu or Mr. M Khurram Iqbal Web Programmer Phone: 3634 7611 - 14, Ext 3309 Email: khurram.iqbal@aku.edu Open Learning Aga Khan University, Institute for Educational Development IED-PDC 1-5/B-VII, Federal B Area Karimabad, P.O. Box 13688 Karachi, 75950 Tel: + 92 21 3634 7611 - 4 Ext. 3912 Fax: + 92 21 3634 7616 Email: ied.openlearning@aku.edu For all technical support and help calls related to Elluminate Live!, please contact the IS Help at telephone extension: 3302 or ied.ishelp@aku.edu