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): 

 
Department: 

 
Home Phone (include area code):

 
Office Phone:

 
Email Address: ex. jdoe@domainname.com

 
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:



 
Instruction Should Include:


 
Note: