Library Instruction Request Form

Please be sure to:
• Provide all of the requested information so that we may better prepare for your session.
• Submit only one class session at a time.
• Submit your request 10 working days in advance of the instruction date request.

Email

Please enter your email address so that you may receive a confirmation of your request.
Name Name First Last
Please enter your first and last name.
Phone Phone - ### - ### ####

Please enter your campus phone extension so that we may contact you if needed.
Course Name and Number

Please enter your course name and number here.
Days Class Meets

Days Class Meets Monday Tuesday Wednesday Thursday Friday Saturday
Class Beginning Time Class Beginning Time : HH MM AM/PM

Please enter the time your class begins.
Class Ending Time Class Ending Time : HH MM AM/PM

Please enter the time your class ends.
Number of Students

Please enter the number of students that will be attending the session.
Special Needs Students

Special Needs Students Yes No

Please choose whether or not your class has any special needs students.
If YES, Please Specify the Special Needs Here:
Please choose a date and time for your session:
Note: The course instructor's attendance is required at all library instruction sessions.
First Choice Date First Choice Date / MM / DD YYYY
First Choice Time First Choice Time : HH MM AM/PM
Second Choice Date Second Choice Date / MM / DD YYYY
Second Choice Time Second Choice Time : HH MM AM/PM
Third Choice Date Third Choice Date / MM / DD YYYY
Third Choice Time Third Choice Time : HH MM AM/PM
Additional Information:
To help us prepare for the session(s), briefly describe your class assignment/need:
We find library instruction to be most beneficial for students who are working on a research assignment and are made aware of the requirements of that assignment before attending a library instruction session.
Learning Objectives for the session (check all that apply):

Learning Objectives for the session (check all that apply): Create effective searches using appropriate key words and concepts (selecting search terms and using Boolean Operators, etc.) Select appropriate library research tools for their information need Locate existing information from various sources (to use in a course assignment and combine with original thought or analysis to produce new information) Identify the purpose and audience of potential information sources (popular vs. scholarly, current vs. historical)
Other:
Please suggest relevant sample topics:

This will help the library instructor prepare relevant hands-on demonstrations
Please give any additional information that will help us provide your students with beneficial instruction session(s), request a specific instructor:

Library Instruction Request Form

Library Instruction Request Form

Please choose a date and time for your session: Note: The course instructor's attendance is required at all library instruction sessions.

Additional Information:

We find library instruction to be most beneficial for students who are working on a research assignment and are made aware of the requirements of that assignment before attending a library instruction session.

Please choose a date and time for your session:
Note: The course instructor's attendance is required at all library instruction sessions.