Instructor's Name:            Date: 

Phone Number:      Email Address: 

Class Number/Department: 

Preferred date(s)/times of class: 

Number of Students in Class: 

Specific resources to be covered & any focus the teacher has in mind (e.g. research topic or paper topics): 

Do you want a library tour? Yes No

Is there an assignment for the class? Yes No

If so, could we have a copy in advance (please send to Kathy Swanson, 213A Resources Center)