BI Request Form

Library Instruction Request Form

Please fill out the following form and submit. Please submit a separate form for each library class requested. Your request should be submitted at least one week prior to the date you would like the session. All instructors should attend the library session with their class. If you have any questions, e-mail Annette Fisher, Library Instruction Coordinator, or call 570-348-6211, ext. 2365.

Your Full Name:

Your E-mail Address:

Telephone Number:

Campus Address:

Course Number

Course Name:

Number of Students in Class:

Any Special Needs Students

If YES, please specify why

Indicate possible dates and times in priority order:

First Choice:

Second Choice:

Third Choice:

Please briefly describe your class assignment, topics you want included
and what you would like students to learn from this library instruction:

Would you like any suggestions for a library related assignment:

Any additional questions or comments:

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Last updated in Fall 2006
Created and maintained by Miao Hong
Contact library@marywood.edu,
Marywood University Library