Please fill out form completely, then click the "Submit" button. Completing form thoroughly will allow us to serve you better. You will be contacted by a library staff member, as soon as possible, to confirm the arrangements. NOTE: As the instructor of record, faculty are required to remain with all classes during instruction sessions.

Faculty Name (first and last): 


Home Phone (include area code):

Office Phone:

Email Address: ex.

Class Time:

Course Title/Number:

Days and Times Taught:

Distance Education Course:

Delivery Format:

Number of Students:

Preferred Date and Time: 1st Choice:

Preferred Date and Time: 2nd Choice:

Preferred Date and Time: 3rd Choice:

Class Assignment:

Please email any documents related to the assignment (research paper description, syllabus, etc.).

Citation Format: