A MWE which provides the items you are looking for in that specified format can be easily produced, but this version leaves much to be desired. You can manually enter in the math department, course name, date, title and the year.
I notice that the font typeface between the following MWE and your screenshot is different, but I will leave that up to you to find the font your teachers are using and incorporate that your own way.
I am also assuming that you are specifically referring to a title page, where these contents appear once in the entire document, on the first page.
\documentclass{article}
\title{Department of Name}
\author{Course Name}
\date{TheDate \hspace{1cm} TheTitle \hspace{1cm} TheYear}
\begin{document}
\maketitle
\pagebreak
Notes or Exercises start here
\end{document}
hspace{value}
denotes a specific amount of horizontal space to be added to the document at the specified position.
Ideally, as @David Carlisle pointed out, you would be better off to get the source that your teacher uses, that way you would have no complications and the output should be the exact same.
titling
package.\maketitle
) a header as those made withfancyhdr
package, or just plain text at the beginning of the page, with more or less that format. It is also unclear if you want the fields with colored boxes, as painted, or just text in colors. Said that, not always is a good idea follow the teacher style...