Instructor's First Name
Instructor's Last Name
Phone Number
Email Address
Course Name and Number
Section Number
Number of Students
What is your preference for offering research instruction to your students?
The librarian meets students in-person in your classroom or in the library
The librarian presents a live online synchronous session through Zoom, Webex, or another service
The librarian creates an asynchronous online learning resource for your class, such as video recordings and/or a research guide
Will anyone in your class need disability accommodations?
Yes
No
Comments/Notes?
Date and Time
(Please provide three optional dates and your class time below)
First Date
Second Date
Third Date
Start Time
Start time hour
1
2
3
4
5
6
7
8
9
10
11
12
Start time minutes
00
05
10
15
20
25
30
35
40
45
50
55
End time meridian
AM
PM
End Time
End time hour
1
2
3
4
5
6
7
8
9
10
11
12
End time minute
00
05
10
15
20
25
30
35
40
45
50
55
End time meridian
AM
PM
Attach the assignment here
(Word or PDF)
Any additional notes, such as specific topics or resources you would like the session to include?