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Instruction Request Form

Name* (Required)
Email* (Required)
Contact Phone Number* (Required)
Library, Subject Area* (Required)
Daley Library, Humanities & Social Sciences
Science Library, Sciences (including Math & Engineering)
LHS-Chicago, Health Sciences
LHS-Peoria, Health Sciences
CLHS-Rockford, Health Sciences
LHS-Urbana, Health Sciences
Course Title and Number* (Required)
Instruction Session Day* (Required)
Instruction Session Time* (Required)
Instruction Session Day Second Choice* (Required)
Instruction Session Time Second Choice* (Required)
Duration* (Required)
(e.g. 1 hour, 2 hours)
Number of Students Expected* (Required)
What would you llike covered in the instruction session?* (Required)