E-learning module customization request form template helps educators and training providers collect clear requirements for tailoring online learning modules. Use this form to capture key customization needs and align content with instructional goals. The template streamlines intake, clarifies scope, and reduces back-and-forth during planning and approval.

This request form includes fields for full name, email address, organization name, module name, a multiple-choice 'Type of Customization Needed' (Content Update, Design Change, Assessment Addition, Localization, Other), a detailed description field, and preferred completion date.

It is ideal for instructors, course designers, and administrators seeking structured requests for content updates, UI redesigns, assessment additions, or localization projects. The form supports conditional logic, file uploads, and automated notifications to streamline project intake and communication. It's useful for academic courses, corporate L&D, certification programs, and professional development workshops worldwide.

Click "Use This Template" to customize and deploy this free template for efficient e-learning customization requests.