2. If you have any difficulties completing the form below, please contact Michele Keplinger at MicheleK@lgit.org for assistance.

4. To request a new user login for the Online Campus, please complete the form below.
6. New User Information:
8. Name*
9. Email*
11. Job Title*
12. Department
14. Phone Number*
15. Local Government*
17. Does this user require admin rights (ability to assign courses)? *

    1. yes
    2. no
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

* indicates a required field