diff --git a/common/djangoapps/util/tests/test_submit_feedback.py b/common/djangoapps/util/tests/test_submit_feedback.py
index 077765e1d7..35e80c83d5 100644
--- a/common/djangoapps/util/tests/test_submit_feedback.py
+++ b/common/djangoapps/util/tests/test_submit_feedback.py
@@ -11,8 +11,19 @@ from util import views
 from zendesk import ZendeskError
 import json
 import mock
+from ddt import ddt, data, unpack
 
 from student.tests.test_configuration_overrides import fake_get_value
+from student.tests.factories import CourseEnrollmentFactory
+
+TEST_SUPPORT_EMAIL = "support@example.com"
+TEST_ZENDESK_CUSTOM_FIELD_CONFIG = {"course_id": 1234, "enrollment_mode": 5678}
+TEST_REQUEST_HEADERS = {
+    "HTTP_REFERER": "test_referer",
+    "HTTP_USER_AGENT": "test_user_agent",
+    "REMOTE_ADDR": "1.2.3.4",
+    "SERVER_NAME": "test_server",
+}
 
 
 def fake_support_backend_values(name, default=None):  # pylint: disable=unused-argument
@@ -21,13 +32,20 @@ def fake_support_backend_values(name, default=None):  # pylint: disable=unused-a
     """
     config_dict = {
         "CONTACT_FORM_SUBMISSION_BACKEND": "email",
-        "email_from_address": "support_from@example.com",
+        "email_from_address": TEST_SUPPORT_EMAIL,
     }
     return config_dict[name]
 
 
+@ddt
 @mock.patch.dict("django.conf.settings.FEATURES", {"ENABLE_FEEDBACK_SUBMISSION": True})
-@override_settings(ZENDESK_URL="dummy", ZENDESK_USER="dummy", ZENDESK_API_KEY="dummy")
+@override_settings(
+    DEFAULT_FROM_EMAIL=TEST_SUPPORT_EMAIL,
+    ZENDESK_URL="dummy",
+    ZENDESK_USER="dummy",
+    ZENDESK_API_KEY="dummy",
+    ZENDESK_CUSTOM_FIELDS={}
+)
 @mock.patch("util.views.dog_stats_api")
 @mock.patch("util.views._ZendeskApi", autospec=True)
 class SubmitFeedbackTest(TestCase):
@@ -44,14 +62,12 @@ class SubmitFeedbackTest(TestCase):
             username="test",
             profile__name="Test User"
         )
-        # This contains issue_type and course_id to ensure that tags are submitted correctly
         self._anon_fields = {
             "email": "test@edx.org",
             "name": "Test User",
             "subject": "a subject",
             "details": "some details",
-            "issue_type": "test_issue",
-            "course_id": "test_course"
+            "issue_type": "test_issue"
         }
         # This does not contain issue_type nor course_id to ensure that they are optional
         self._auth_fields = {"subject": "a subject", "details": "some details"}
@@ -66,10 +82,10 @@ class SubmitFeedbackTest(TestCase):
         req = self._request_factory.post(
             "/submit_feedback",
             data=fields,
-            HTTP_REFERER="test_referer",
-            HTTP_USER_AGENT="test_user_agent",
-            REMOTE_ADDR="1.2.3.4",
-            SERVER_NAME="test_server",
+            HTTP_REFERER=TEST_REQUEST_HEADERS["HTTP_REFERER"],
+            HTTP_USER_AGENT=TEST_REQUEST_HEADERS["HTTP_USER_AGENT"],
+            REMOTE_ADDR=TEST_REQUEST_HEADERS["REMOTE_ADDR"],
+            SERVER_NAME=TEST_REQUEST_HEADERS["SERVER_NAME"],
         )
         req.user = user
         return views.submit_feedback(req)
@@ -130,13 +146,58 @@ class SubmitFeedbackTest(TestCase):
         resp = self._build_and_run_request(user, fields)
         self.assertEqual(resp.status_code, 200)
 
-    def _assert_datadog_called(self, datadog_mock, with_tags):
-        expected_datadog_calls = [
-            mock.call.increment(
-                views.DATADOG_FEEDBACK_METRIC,
-                tags=(["course_id:test_course", "issue_type:test_issue"] if with_tags else [])
-            )
+    def _build_zendesk_ticket(self, recipient, name, email, subject, details, tags, custom_fields=None):
+        """
+        Build a Zendesk ticket that can be used in assertions to verify that the correct
+        data was submitted to create a Zendesk ticket.
+        """
+        ticket = {
+            "ticket": {
+                "recipient": recipient,
+                "requester": {"name": name, "email": email},
+                "subject": subject,
+                "comment": {"body": details},
+                "tags": tags
+            }
+        }
+
+        if custom_fields is not None:
+            ticket["ticket"]["custom_fields"] = custom_fields
+
+        return ticket
+
+    def _build_zendesk_ticket_update(self, request_headers, username=None):
+        """
+        Build a Zendesk ticket update that can be used in assertions to verify that the correct
+        data was submitted to update a Zendesk ticket.
+        """
+        body = []
+        if username:
+            body.append("username: {}".format(username))
+
+        # FIXME the tests rely on the body string being built in this specific order, which doesn't seem
+        # reliable given that the view builds the string by iterating over a dictionary.
+        header_text_mapping = [
+            ("Client IP", "REMOTE_ADDR"),
+            ("Host", "SERVER_NAME"),
+            ("Page", "HTTP_REFERER"),
+            ("Browser", "HTTP_USER_AGENT")
         ]
+
+        for text, header in header_text_mapping:
+            body.append("{}: {}".format(text, request_headers[header]))
+
+        body = "Additional information:\n\n" + "\n".join(body)
+        return {"ticket": {"comment": {"public": False, "body": body}}}
+
+    def _assert_zendesk_called(self, zendesk_mock, ticket_id, ticket, ticket_update):
+        """Assert that Zendesk was called with the correct ticket and ticket_update."""
+        expected_zendesk_calls = [mock.call.create_ticket(ticket), mock.call.update_ticket(ticket_id, ticket_update)]
+        self.assertEqual(zendesk_mock.mock_calls, expected_zendesk_calls)
+
+    def _assert_datadog_called(self, datadog_mock, tags):
+        """Assert that datadog was called with the correct tags."""
+        expected_datadog_calls = [mock.call.increment(views.DATADOG_FEEDBACK_METRIC, tags=tags)]
         self.assertEqual(datadog_mock.mock_calls, expected_datadog_calls)
 
     def test_bad_request_anon_user_no_name(self, zendesk_mock_class, datadog_mock):
@@ -174,39 +235,26 @@ class SubmitFeedbackTest(TestCase):
         the given information should have been submitted via the Zendesk API.
         """
         zendesk_mock_instance = zendesk_mock_class.return_value
-        zendesk_mock_instance.create_ticket.return_value = 42
-        self._test_success(self._anon_user, self._anon_fields)
-        expected_zendesk_calls = [
-            mock.call.create_ticket(
-                {
-                    "ticket": {
-                        "recipient": "registration@example.com",
-                        "requester": {"name": "Test User", "email": "test@edx.org"},
-                        "subject": "a subject",
-                        "comment": {"body": "some details"},
-                        "tags": ["test_course", "test_issue", "LMS"]
-                    }
-                }
-            ),
-            mock.call.update_ticket(
-                42,
-                {
-                    "ticket": {
-                        "comment": {
-                            "public": False,
-                            "body":
-                            "Additional information:\n\n"
-                            "Client IP: 1.2.3.4\n"
-                            "Host: test_server\n"
-                            "Page: test_referer\n"
-                            "Browser: test_user_agent"
-                        }
-                    }
-                }
-            )
-        ]
-        self.assertEqual(zendesk_mock_instance.mock_calls, expected_zendesk_calls)
-        self._assert_datadog_called(datadog_mock, with_tags=True)
+        user = self._anon_user
+        fields = self._anon_fields
+
+        ticket_id = 42
+        zendesk_mock_instance.create_ticket.return_value = ticket_id
+
+        ticket = self._build_zendesk_ticket(
+            recipient=TEST_SUPPORT_EMAIL,
+            name=fields["name"],
+            email=fields["email"],
+            subject=fields["subject"],
+            details=fields["details"],
+            tags=[fields["issue_type"], "LMS"]
+        )
+
+        ticket_update = self._build_zendesk_ticket_update(TEST_REQUEST_HEADERS)
+
+        self._test_success(user, fields)
+        self._assert_zendesk_called(zendesk_mock_instance, ticket_id, ticket, ticket_update)
+        self._assert_datadog_called(datadog_mock, ["issue_type:{}".format(fields["issue_type"])])
 
     @mock.patch("openedx.core.djangoapps.site_configuration.helpers.get_value", fake_get_value)
     def test_valid_request_anon_user_configuration_override(self, zendesk_mock_class, datadog_mock):
@@ -218,39 +266,75 @@ class SubmitFeedbackTest(TestCase):
         tag that will come from site configuration override.
         """
         zendesk_mock_instance = zendesk_mock_class.return_value
-        zendesk_mock_instance.create_ticket.return_value = 42
-        self._test_success(self._anon_user, self._anon_fields)
-        expected_zendesk_calls = [
-            mock.call.create_ticket(
-                {
-                    "ticket": {
-                        "recipient": "no-reply@fakeuniversity.com",
-                        "requester": {"name": "Test User", "email": "test@edx.org"},
-                        "subject": "a subject",
-                        "comment": {"body": "some details"},
-                        "tags": ["test_course", "test_issue", "LMS", "whitelabel_fakeorg"]
-                    }
-                }
-            ),
-            mock.call.update_ticket(
-                42,
-                {
-                    "ticket": {
-                        "comment": {
-                            "public": False,
-                            "body":
-                            "Additional information:\n\n"
-                            "Client IP: 1.2.3.4\n"
-                            "Host: test_server\n"
-                            "Page: test_referer\n"
-                            "Browser: test_user_agent"
-                        }
-                    }
-                }
-            )
-        ]
-        self.assertEqual(zendesk_mock_instance.mock_calls, expected_zendesk_calls)
-        self._assert_datadog_called(datadog_mock, with_tags=True)
+        user = self._anon_user
+        fields = self._anon_fields
+
+        ticket_id = 42
+        zendesk_mock_instance.create_ticket.return_value = ticket_id
+
+        ticket = self._build_zendesk_ticket(
+            recipient=fake_get_value("email_from_address"),
+            name=fields["name"],
+            email=fields["email"],
+            subject=fields["subject"],
+            details=fields["details"],
+            tags=[fields["issue_type"], "LMS", "whitelabel_{}".format(fake_get_value("course_org_filter"))]
+        )
+
+        ticket_update = self._build_zendesk_ticket_update(TEST_REQUEST_HEADERS)
+
+        self._test_success(user, fields)
+        self._assert_zendesk_called(zendesk_mock_instance, ticket_id, ticket, ticket_update)
+        self._assert_datadog_called(datadog_mock, ["issue_type:{}".format(fields["issue_type"])])
+
+    @data("course-v1:testOrg+testCourseNumber+testCourseRun", "", None)
+    @override_settings(ZENDESK_CUSTOM_FIELDS=TEST_ZENDESK_CUSTOM_FIELD_CONFIG)
+    def test_valid_request_anon_user_with_custom_fields(self, course_id, zendesk_mock_class, datadog_mock):
+        """
+        Test a valid request from an anonymous user when configured to use Zendesk Custom Fields.
+
+        The response should have a 200 (success) status code, and a ticket with
+        the given information should have been submitted via the Zendesk API. When course_id is
+        present, it should be sent to Zendesk via a custom field. When course_id is blank or missing,
+        the request should still be processed successfully.
+        """
+        zendesk_mock_instance = zendesk_mock_class.return_value
+        user = self._anon_user
+
+        fields = self._anon_fields.copy()
+        if course_id is not None:
+            fields["course_id"] = course_id
+
+        ticket_id = 42
+        zendesk_mock_instance.create_ticket.return_value = ticket_id
+
+        zendesk_tags = [fields["issue_type"], "LMS"]
+        datadog_tags = ["issue_type:{}".format(fields["issue_type"])]
+        zendesk_custom_fields = None
+        if course_id:
+            # FIXME the tests rely on the tags being in this specific order, which doesn't seem
+            # reliable given that the view builds the list by iterating over a dictionary.
+            zendesk_tags.insert(0, course_id)
+            datadog_tags.insert(0, "course_id:{}".format(course_id))
+            zendesk_custom_fields = [
+                {"id": TEST_ZENDESK_CUSTOM_FIELD_CONFIG["course_id"], "value": course_id}
+            ]
+
+        ticket = self._build_zendesk_ticket(
+            recipient=TEST_SUPPORT_EMAIL,
+            name=fields["name"],
+            email=fields["email"],
+            subject=fields["subject"],
+            details=fields["details"],
+            tags=zendesk_tags,
+            custom_fields=zendesk_custom_fields
+        )
+
+        ticket_update = self._build_zendesk_ticket_update(TEST_REQUEST_HEADERS)
+
+        self._test_success(user, fields)
+        self._assert_zendesk_called(zendesk_mock_instance, ticket_id, ticket, ticket_update)
+        self._assert_datadog_called(datadog_mock, datadog_tags)
 
     def test_bad_request_auth_user_no_subject(self, zendesk_mock_class, datadog_mock):
         """Test a request from an authenticated user not specifying `subject`."""
@@ -270,40 +354,92 @@ class SubmitFeedbackTest(TestCase):
         the given information should have been submitted via the Zendesk API.
         """
         zendesk_mock_instance = zendesk_mock_class.return_value
-        zendesk_mock_instance.create_ticket.return_value = 42
-        self._test_success(self._auth_user, self._auth_fields)
-        expected_zendesk_calls = [
-            mock.call.create_ticket(
-                {
-                    "ticket": {
-                        "recipient": "registration@example.com",
-                        "requester": {"name": "Test User", "email": "test@edx.org"},
-                        "subject": "a subject",
-                        "comment": {"body": "some details"},
-                        "tags": ["LMS"]
-                    }
-                }
-            ),
-            mock.call.update_ticket(
-                42,
-                {
-                    "ticket": {
-                        "comment": {
-                            "public": False,
-                            "body":
-                            "Additional information:\n\n"
-                            "username: test\n"
-                            "Client IP: 1.2.3.4\n"
-                            "Host: test_server\n"
-                            "Page: test_referer\n"
-                            "Browser: test_user_agent"
-                        }
-                    }
-                }
-            )
-        ]
-        self.assertEqual(zendesk_mock_instance.mock_calls, expected_zendesk_calls)
-        self._assert_datadog_called(datadog_mock, with_tags=False)
+        user = self._auth_user
+        fields = self._auth_fields
+
+        ticket_id = 42
+        zendesk_mock_instance.create_ticket.return_value = ticket_id
+
+        ticket = self._build_zendesk_ticket(
+            recipient=TEST_SUPPORT_EMAIL,
+            name=user.profile.name,
+            email=user.email,
+            subject=fields["subject"],
+            details=fields["details"],
+            tags=["LMS"]
+        )
+
+        ticket_update = self._build_zendesk_ticket_update(TEST_REQUEST_HEADERS, user.username)
+
+        self._test_success(user, fields)
+        self._assert_zendesk_called(zendesk_mock_instance, ticket_id, ticket, ticket_update)
+        self._assert_datadog_called(datadog_mock, [])
+
+    @data(
+        ("course-v1:testOrg+testCourseNumber+testCourseRun", True),
+        ("course-v1:testOrg+testCourseNumber+testCourseRun", False),
+        ("", None),
+        (None, None)
+    )
+    @unpack
+    @override_settings(ZENDESK_CUSTOM_FIELDS=TEST_ZENDESK_CUSTOM_FIELD_CONFIG)
+    def test_valid_request_auth_user_with_custom_fields(self, course_id, enrolled, zendesk_mock_class, datadog_mock):
+        """
+        Test a valid request from an authenticated user when configured to use Zendesk Custom Fields.
+
+        The response should have a 200 (success) status code, and a ticket with
+        the given information should have been submitted via the Zendesk API. When course_id is
+        present, it should be sent to Zendesk via a custom field, along with the enrollment mode
+        if the user has an active enrollment for that course. When course_id is blank or missing,
+        the request should still be processed successfully.
+        """
+        zendesk_mock_instance = zendesk_mock_class.return_value
+        user = self._auth_user
+
+        fields = self._auth_fields.copy()
+        if course_id is not None:
+            fields["course_id"] = course_id
+
+        ticket_id = 42
+        zendesk_mock_instance.create_ticket.return_value = ticket_id
+
+        zendesk_tags = ["LMS"]
+        datadog_tags = []
+        zendesk_custom_fields = None
+        if course_id:
+            # FIXME the tests rely on the tags being in this specific order, which doesn't seem
+            # reliable given that the view builds the list by iterating over a dictionary.
+            zendesk_tags.insert(0, course_id)
+            datadog_tags.insert(0, "course_id:{}".format(course_id))
+            zendesk_custom_fields = [
+                {"id": TEST_ZENDESK_CUSTOM_FIELD_CONFIG["course_id"], "value": course_id}
+            ]
+            if enrolled is not None:
+                enrollment = CourseEnrollmentFactory.create(
+                    user=user,
+                    course_id=course_id,
+                    is_active=enrolled
+                )
+                if enrollment.is_active:
+                    zendesk_custom_fields.append(
+                        {"id": TEST_ZENDESK_CUSTOM_FIELD_CONFIG["enrollment_mode"], "value": enrollment.mode}
+                    )
+
+        ticket = self._build_zendesk_ticket(
+            recipient=TEST_SUPPORT_EMAIL,
+            name=user.profile.name,
+            email=user.email,
+            subject=fields["subject"],
+            details=fields["details"],
+            tags=zendesk_tags,
+            custom_fields=zendesk_custom_fields
+        )
+
+        ticket_update = self._build_zendesk_ticket_update(TEST_REQUEST_HEADERS, user.username)
+
+        self._test_success(user, fields)
+        self._assert_zendesk_called(zendesk_mock_instance, ticket_id, ticket, ticket_update)
+        self._assert_datadog_called(datadog_mock, datadog_tags)
 
     def test_get_request(self, zendesk_mock_class, datadog_mock):
         """Test that a GET results in a 405 even with all required fields"""
@@ -329,7 +465,7 @@ class SubmitFeedbackTest(TestCase):
         resp = self._build_and_run_request(self._anon_user, self._anon_fields)
         self.assertEqual(resp.status_code, 500)
         self.assertFalse(resp.content)
-        self._assert_datadog_called(datadog_mock, with_tags=True)
+        self._assert_datadog_called(datadog_mock, ["issue_type:{}".format(self._anon_fields["issue_type"])])
 
     def test_zendesk_error_on_update(self, zendesk_mock_class, datadog_mock):
         """
@@ -344,7 +480,7 @@ class SubmitFeedbackTest(TestCase):
         zendesk_mock_instance.update_ticket.side_effect = err
         resp = self._build_and_run_request(self._anon_user, self._anon_fields)
         self.assertEqual(resp.status_code, 200)
-        self._assert_datadog_called(datadog_mock, with_tags=True)
+        self._assert_datadog_called(datadog_mock, ["issue_type:{}".format(self._anon_fields["issue_type"])])
 
     @mock.patch.dict("django.conf.settings.FEATURES", {"ENABLE_FEEDBACK_SUBMISSION": False})
     def test_not_enabled(self, zendesk_mock_class, datadog_mock):
diff --git a/common/djangoapps/util/views.py b/common/djangoapps/util/views.py
index ea886e7777..2c7045b540 100644
--- a/common/djangoapps/util/views.py
+++ b/common/djangoapps/util/views.py
@@ -25,6 +25,7 @@ from edxmako.shortcuts import render_to_response, render_to_string
 from openedx.core.djangoapps.site_configuration import helpers as configuration_helpers
 import track.views
 from student.roles import GlobalStaff
+from student.models import CourseEnrollment
 
 log = logging.getLogger(__name__)
 
@@ -222,6 +223,40 @@ class _ZendeskApi(object):
         return None
 
 
+def _get_zendesk_custom_field_context(request):
+    """
+    Construct a dictionary of data that can be stored in Zendesk custom fields.
+    """
+    context = {}
+
+    course_id = request.POST.get("course_id")
+    if not course_id:
+        return context
+
+    context["course_id"] = course_id
+    if not request.user.is_authenticated():
+        return context
+
+    enrollment = CourseEnrollment.get_enrollment(request.user, CourseKey.from_string(course_id))
+    if enrollment and enrollment.is_active:
+        context["enrollment_mode"] = enrollment.mode
+
+    return context
+
+
+def _format_zendesk_custom_fields(context):
+    """
+    Format the data in `context` for compatibility with the Zendesk API.
+    Ignore any keys that have not been configured in `ZENDESK_CUSTOM_FIELDS`.
+    """
+    custom_fields = []
+    for key, val, in settings.ZENDESK_CUSTOM_FIELDS.items():
+        if key in context:
+            custom_fields.append({"id": val, "value": context[key]})
+
+    return custom_fields
+
+
 def _record_feedback_in_zendesk(
         realname,
         email,
@@ -231,7 +266,8 @@ def _record_feedback_in_zendesk(
         additional_info,
         group_name=None,
         require_update=False,
-        support_email=None
+        support_email=None,
+        custom_fields=None
 ):
     """
     Create a new user-requested Zendesk ticket.
@@ -246,6 +282,8 @@ def _record_feedback_in_zendesk(
     If `require_update` is provided, returns False when the update does not
     succeed. This allows using the private comment to add necessary information
     which the user will not see in followup emails from support.
+
+    If `custom_fields` is provided, submits data to those fields in Zendesk.
     """
     zendesk_api = _ZendeskApi()
 
@@ -271,6 +309,10 @@ def _record_feedback_in_zendesk(
             "tags": zendesk_tags
         }
     }
+
+    if custom_fields:
+        new_ticket["ticket"]["custom_fields"] = custom_fields
+
     group = None
     if group_name is not None:
         group = zendesk_api.get_group(group_name)
@@ -322,7 +364,7 @@ def get_feedback_form_context(request):
     context["subject"] = request.POST["subject"]
     context["details"] = request.POST["details"]
     context["tags"] = dict(
-        [(tag, request.POST[tag]) for tag in ["issue_type", "course_id"] if tag in request.POST]
+        [(tag, request.POST[tag]) for tag in ["issue_type", "course_id"] if request.POST.get(tag)]
     )
 
     context["additional_info"] = {}
@@ -412,6 +454,11 @@ def submit_feedback(request):
         if not settings.ZENDESK_URL or not settings.ZENDESK_USER or not settings.ZENDESK_API_KEY:
             raise Exception("Zendesk enabled but not configured")
 
+        custom_fields = None
+        if settings.ZENDESK_CUSTOM_FIELDS:
+            custom_field_context = _get_zendesk_custom_field_context(request)
+            custom_fields = _format_zendesk_custom_fields(custom_field_context)
+
         success = _record_feedback_in_zendesk(
             context["realname"],
             context["email"],
@@ -419,7 +466,8 @@ def submit_feedback(request):
             context["details"],
             context["tags"],
             context["additional_info"],
-            support_email=context["support_email"]
+            support_email=context["support_email"],
+            custom_fields=custom_fields
         )
 
     _record_feedback_in_datadog(context["tags"])
diff --git a/lms/envs/aws.py b/lms/envs/aws.py
index 340c2079fa..3e85617b0f 100644
--- a/lms/envs/aws.py
+++ b/lms/envs/aws.py
@@ -333,6 +333,8 @@ COMMENTS_SERVICE_URL = ENV_TOKENS.get("COMMENTS_SERVICE_URL", '')
 COMMENTS_SERVICE_KEY = ENV_TOKENS.get("COMMENTS_SERVICE_KEY", '')
 CERT_QUEUE = ENV_TOKENS.get("CERT_QUEUE", 'test-pull')
 ZENDESK_URL = ENV_TOKENS.get('ZENDESK_URL', ZENDESK_URL)
+ZENDESK_CUSTOM_FIELDS = ENV_TOKENS.get('ZENDESK_CUSTOM_FIELDS', ZENDESK_CUSTOM_FIELDS)
+
 FEEDBACK_SUBMISSION_EMAIL = ENV_TOKENS.get("FEEDBACK_SUBMISSION_EMAIL")
 MKTG_URLS = ENV_TOKENS.get('MKTG_URLS', MKTG_URLS)
 
diff --git a/lms/envs/common.py b/lms/envs/common.py
index 6c58a774cf..c826fd1b9f 100644
--- a/lms/envs/common.py
+++ b/lms/envs/common.py
@@ -1003,6 +1003,7 @@ FEEDBACK_SUBMISSION_EMAIL = None
 ZENDESK_URL = None
 ZENDESK_USER = None
 ZENDESK_API_KEY = None
+ZENDESK_CUSTOM_FIELDS = {}
 
 ##### EMBARGO #####
 EMBARGO_SITE_REDIRECT_URL = None
diff --git a/lms/static/sass/_build-lms-v1.scss b/lms/static/sass/_build-lms-v1.scss
index bb376fec9f..460e2dbc2d 100644
--- a/lms/static/sass/_build-lms-v1.scss
+++ b/lms/static/sass/_build-lms-v1.scss
@@ -35,6 +35,7 @@
 @import 'shared/modal';
 @import 'shared/activation_messages';
 @import 'shared/unsubscribe';
+@import 'shared/help-tab';
 
 // shared - platform
 @import 'multicourse/home';
diff --git a/lms/static/sass/shared-v2/_help-tab.scss b/lms/static/sass/shared-v2/_help-tab.scss
index 080c5f4e6c..99cf9b3836 100644
--- a/lms/static/sass/shared-v2/_help-tab.scss
+++ b/lms/static/sass/shared-v2/_help-tab.scss
@@ -78,3 +78,9 @@
         padding: 0 $baseline $baseline;
     }
 }
+
+.feedback-form-select {
+    background: $white;
+    margin-bottom: $baseline;
+    width: 100%;
+}
diff --git a/lms/static/sass/shared/_help-tab.scss b/lms/static/sass/shared/_help-tab.scss
new file mode 100644
index 0000000000..7af1407ac0
--- /dev/null
+++ b/lms/static/sass/shared/_help-tab.scss
@@ -0,0 +1,5 @@
+.feedback-form-select {
+    background: $white;
+    margin-bottom: $baseline;
+    width: 100%;
+}
diff --git a/lms/templates/help_modal.html b/lms/templates/help_modal.html
index abe1779d99..5198e893c1 100644
--- a/lms/templates/help_modal.html
+++ b/lms/templates/help_modal.html
@@ -99,15 +99,21 @@ from xmodule.tabs import CourseTabList
           <label data-field="email" for="feedback_form_email">${_('E-mail')}*</label>
           <input name="email" type="text" id="feedback_form_email" required>
     % endif
+
+          <div class="js-course-id-anchor">
+              % if course:
+                  <input name="course_id" type="hidden" value="${unicode(course.id)}">
+              % endif
+          </div>
+
           <label data-field="subject" for="feedback_form_subject">${_('Briefly describe your issue')}*</label>
           <input name="subject" type="text" id="feedback_form_subject" required>
+
           <label data-field="details" for="feedback_form_details">${_('Tell us the details')}*</label>
           <span class="tip" id="feedback_form_details_tip">${_('Describe what you were doing when you encountered the issue. Include any details that will help us to troubleshoot, including error messages that you saw.')}</span>
           <textarea name="details" id="feedback_form_details" required aria-describedby="feedback_form_details_tip"></textarea>
+
           <input name="issue_type" type="hidden">
-    % if course:
-          <input name="course_id" type="hidden" value="${unicode(course.id)}">
-    % endif
           <div class="submit">
             <input name="submit" type="submit" value="${_('Submit')}" id="feedback_submit">
           </div>
@@ -138,7 +144,12 @@ from xmodule.tabs import CourseTabList
 
 <script type="text/javascript">
 $(document).ready(function() {
-    var $helpModal = $("#help-modal"),
+    var currentCourseId,
+        courseOptions = [],
+        userAuthenticated = false,
+        courseOptionsLoadInProgress = false,
+        finishedLoadingCourseOptions = false,
+        $helpModal = $("#help-modal"),
         $closeButton = $("#help-modal .close-modal"),
         $leanOverlay = $("#lean_overlay"),
         $feedbackForm = $("#feedback_form"),
@@ -149,11 +160,101 @@ $(document).ready(function() {
             $('area,input,select,textarea,button').removeAttr('tabindex');
             $(".help-tab a").focus();
             $leanOverlay.removeAttr('tabindex');
+        },
+        showFeedback = function(event, issue_type, title, subject_label, details_label) {
+            event.preventDefault();
+            DialogTabControls.initializeTabKeyValues("#feedback_form_wrapper", $closeButton);
+            $("#feedback_form input[name='issue_type']").val(issue_type);
+            $("#feedback_form_wrapper header").html("<h2>" + title + "</h2><hr>");
+            $("#feedback_form_wrapper label[data-field='subject']").html(subject_label);
+            $("#feedback_form_wrapper label[data-field='details']").html(details_label);
+            if (userAuthenticated && finishedLoadingCourseOptions && courseOptions.length > 1) {
+                $('.js-course-id-anchor').html([
+                    '<label for="feedback_form_course">' + '${_("Course") | n, js_escaped_string}' + '</label>',
+                    '<select name="course_id" id="feedback_form_course" class="feedback-form-select">',
+                    courseOptions.join(''),
+                    '</select>'
+                ].join(''));
+            }
+            $("#help_wrapper").css("display", "none");
+            $("#feedback_form_wrapper").css("display", "block");
+            $closeButton.focus();
+        },
+        loadCourseOptions = function() {
+            courseOptionsLoadInProgress = true;
+            $.ajax({
+                url: '/api/enrollment/v1/enrollment',
+                success: function(data) {
+                    var i,
+                        courseDetails,
+                        courseName,
+                        courseId,
+                        option,
+                        defaultOptionText = '${_("- Select -") | n, js_escaped_string}',
+                        markedSelectedOption = false;
+
+                    // Make sure courseOptions is empty before we begin pushing options into it.
+                    courseOptions = [];
+
+                    for (i = 0; i < data.length; i++) {
+                        courseDetails = data[i].course_details;
+                        if (!courseDetails) {
+                            continue;
+                        }
+
+                        courseName = courseDetails.course_name;
+                        courseId = courseDetails.course_id;
+                        if (!(courseName && courseId)) {
+                            continue;
+                        }
+
+                        // Build an option for this course and select it if it's the course we're currently viewing.
+                        if (!markedSelectedOption && courseId === currentCourseId) {
+                            option = buildCourseOption(courseName, courseId, true);
+                            markedSelectedOption = true;
+                        } else {
+                            option = buildCourseOption(courseName, courseId, false);
+                        }
+
+                        courseOptions.push(option);
+                    }
+
+                    // Build the default option and select it if we haven't already selected another option.
+                    option = buildCourseOption(defaultOptionText, '', !markedSelectedOption);
+
+                    // Add the default option to the head of the courseOptions Array.
+                    courseOptions.unshift(option);
+
+                    finishedLoadingCourseOptions = true;
+                },
+                complete: function() {
+                    courseOptionsLoadInProgress = false;
+                }
+            });
+        },
+        buildCourseOption = function(courseName, courseId, selected) {
+            var option = '<option value="' + _.escape(courseId) + '"';
+            if (selected) {
+                option += ' selected';
+            }
+            option += '>' + _.escape(courseName) + '</option>';
+            return option;
         };
 
+    % if user.is_authenticated():
+        userAuthenticated = true;
+    % endif
+
+    % if course:
+        currentCourseId = "${unicode(course.id) | n, js_escaped_string}";
+    % endif
+
     DialogTabControls.setKeydownListener($helpModal, $closeButton);
 
     $(".help-tab").click(function() {
+        if (userAuthenticated && !finishedLoadingCourseOptions && !courseOptionsLoadInProgress) {
+            loadCourseOptions();
+        }
         $helpModal.css("position", "absolute");
         DialogTabControls.initializeTabKeyValues("#help_wrapper", $closeButton);
         $(".field-error").removeClass("field-error");
@@ -171,18 +272,6 @@ $(document).ready(function() {
         $closeButton.focus();
     });
 
-    showFeedback = function(event, issue_type, title, subject_label, details_label) {
-        $("#help_wrapper").css("display", "none");
-        DialogTabControls.initializeTabKeyValues("#feedback_form_wrapper", $closeButton);
-        $("#feedback_form input[name='issue_type']").val(issue_type);
-        $("#feedback_form_wrapper").css("display", "block");
-        $("#feedback_form_wrapper header").html("<h2>" + title + "</h2><hr>");
-        $("#feedback_form_wrapper label[data-field='subject']").html(subject_label);
-        $("#feedback_form_wrapper label[data-field='details']").html(details_label);
-        $closeButton.focus();
-        event.preventDefault();
-    };
-
     $("#feedback_link_problem").click(function(event) {
         $("#feedback_form_details_tip").css({"display": "block", "padding-bottom": "5px"});
         showFeedback(