Instruction Services - Request a Library Instruction Session

Request a Library Instruction Session - Form
FACULTY/INSTRUCTOR INFORMATION
Instructor Name:
Department/Group:
Phone Number:
Email Address:
COURSE INFORMATION
Number/Title/Topic:	ex: Soc 322: Wmn in 20thC
Meeting Times:	ex: MWF, 10am-11am
Number of Students:
Level of Students:
I teach in a hands-on classroom (each student has a workstation)
	Yes No If yes, room number: (ex. PAR 104)
LIBRARY SESSION INFORMATION
Date and time requested for library session (ex. 4/23, 10am-11am):
1st Choice:
2nd Choice:
3rd Choice:
If you would like to request a specific librarian, please include their name here: *

	* Please note that we will make every effort to accommodate your request based on schedules.
Special Needs (For example, accommodation for persons with disabilities):
ASSIGNMENT INFORMATION
Please check one:
	I will submit my syllabus and assignment Via email to lib-instruction@utlists.utexas.edu Via campus mail to Library Instruction Services, PCL 1.342, S5475
I would like to collaborate with an instruction librarian to update or design a library research assignment.
	Yes No
COMMENTS

Request a Library Instruction Session - Form