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Information Literacy Instruction Request Form

Instructor Name *
Instructor e-mail *
Instructor Phone Number
Will you be attending the class session? *	Yes No
Library policy is that the primary instructor attend the class. Please schedule the class at a time when you can attend.
Department *
Course Name *
Number of Students
Would you prefer your classroom or a computer lab *	Classroom Lab
The Library will attempt to schedule a computer lab for your classtime, but a computer lab can not be guaranteed. We will notify you of the room number once the lab has been scheduled.
Classroom Building	Angelico Guzman Library Science Bldg
Classroom Number
Smart Classroom	Yes No
Class Time *
Please fill in class time
Date *	[MM-dd-yy]
Day of the Week *
Date (2nd Choice) *	[MM-dd-yy]
Day of the Week (2nd Choice) *
Material That you Wish Covered *	Advance use of specific databases Subject specific overview Thesis construction/topic exploration Assignment Specific Research Introduction to RefWorks Using the catalog & other book finding resources Citations/citation tools Other
Please Describe Other
Briefly describe research project assigned
What are your Student Learning Outcomes for this lecture?
Please upload a copy of the assignment or syllabus
Notes
Librarian Assigned
Date Assigned	[MM-dd-yy]
Room/Computer Lab Assigned
Completed	Yes No Canceled Rescheduled
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