1

Instructor:

Instructor:

2

Email/phone:

Email/phone:

3

Class:

Class:

4

Preferred Date time:

Preferred Date time:

5

Alternate Date/Time:

Alternate Date/Time:

6

# of students:

# of students:

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7

Instruction Requests:

Instruction Requests:

Books/eBooks

Citations

Article Databases

Web Resources

Other If other, type text here.

8

What assignment are students working on at this session?

What assignment are students working on at this session?

9

Any other information?

Any other information?

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2. Email Address

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