Instruction by Appointment Request Form

You can use this form to request an appointment regarding instruction.

Instructor:

Instructor's Phone Number:

Instructor's Email Address:

Course Name:

Course Number:

Number of Participants:

First Choice for Instruction Date:

First Choice for Instruction Time:

Specifically, I would like the instructor to cover:

Does this instruction session support an assignment on your syllabus? Yes No

If yes, please be prepared to forward the assignment to the designated librarian.

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