Library Instruction Request Form

Your Name

Email Address

Phone Number

Department

Course Name & Number

Course Title

Number of Students

Day of class meeting

Sunday Saturday Friday Thursday Wednesday Tuesday Monday

Time of class meeting

Preferred Instruction date (Please list 3 options)

1000 characters remaining.

Mode of Instruction

• Virtual
• Face to Face

 Virtual instruction offered for online classes through Blackboard Collaborate.

Class Assignment

1000 characters remaining.

Human Verification

* Required fields