Please complete one form for each course and/or course section you are requesting. Your course will be available by the date requested, and you will receive a confirmation via email. If you have any questions, please do not hesitate to contact Nicki Salcedo, Online Course Support Specialist, at (800) 547-4748, or OnlineSupport@coastline.edu. Our office is open Monday through Friday, 8 a.m. to 5 p.m., PST.

Student Guide/Textbook/Workbook orders must be placed with Kendall/Hunt Publishing Company, www.kendallhunt.com or (800) 228-0810. The print component required for this course includes a One-Time Use/access/Serial Number. Therefore, the print component has no resale value. The course licensing fees and software/content royalties are incorporated into the price of the printed materials. Adoption of the print material is required in order to use the online course content. Students must purchase print material in order to access the course.

Please provide the book ordering information to your bookstore at least six to twelve weeks prior to the start of the semester.

Instructor's Name:


Instructor's E-mail:


Instructor's Phone:


Your position:
Full-time Faculty Member
Part-time (Adjunct) Faculty


Name of Institution:


Institution's Mailing Address (Street, City, State, Zip):


Institutional Contact: (Distance Learning Department or Division Dean)


Institutional Contact's Phone Number:


Institutional Contact's E-mail Address:


Course I will be teaching:
Music Appreciation Online
Music Fundamentals Online
Introduction to Jazz Online
History of Rock & Roll
World Music

CMS I will be using: Moodle Other CMS

If you are using Moodle or have special instructions, please provide the instructor's Coast Learning Systems account information. (e.g. user name, password, admin code).

Term course is to be used:
Fall
Intersession
Spring
Summer
Winter


Date you'd like the Course available to you:
*

Date Term Starts:
*

Date Term Ends:


Please contact me at the E-mail address listed below when my course is ready.
*

Special Instructions: (Such as the course name you'd like listed on the portal, request to copy your course from a previous semester, or other specific instructions.)

Workbook/Textbook Orders:
I do not need assistance with ordering books
Please have someone contact me immediately regarding book orders

Your request cannot be processed until the following agreements are approved.
Thank you.

Agreement between Instructor and the Coast Community College District regarding course content use.

Copyright Responsibility: I understand that I am allowed to add (personalize) content to this course.  I agree and understand that it is my responsibility, duty, and obligation to add only content that is properly and legally acquired.  I hereby agree and accept that I am the sole individual responsible and liable for the content I add to this course. 

Approved - I agree to the terms listed.
Not Approved - Please contact me.

Copyright Ownership Agreement: I understand that I am not entitled to any ownership rights of the content (digital, video, audio, or print) within this course. I shall in no manner infringe, disparage, or challenge CCCD's rights in the content. I understand that it is my responsibility to notify CCCD of any infringement of CCCD's rights of the content and at the request of CCCD take reasonable steps to assist CCCD in protecting its rights of the content. I agree to display and not remove any credits and/or copyright statements.

Agreement:
Approved - I agree to the terms listed.
Not Approved - Please contact me.

Release, Hold Harmless, and Indemnity: I hereby accept this course licensed by CCCD in present form and condition and hereby release and discharge CCCD and each of its trustees, employees, agents and representative from any and all liability arising out of or in connection with my use of this course to the extent permitted by law, shall defend, indemnify and hold CCCD and its respective trustees, employees, agents, and representative free and harmless from and against all claims, liabilities, loss, and expense, including reasonable attorneys' fees and court costs which may arise because of the negligence, misconduct, or other fault of mine or in any way resulting from my performance of my obligations under this agreement.

Release, Hold Harmless and Indemnity:
Approved - I agree to the terms listed.
Not Approved - Please contact me.


Please click submit button just once. You will receive a copy of your course set-up request once it has been received by Coast Learning Systems. If you do not receive confirmation within 72 hours, please contact our office at (800) 547-4748.