Instruction Request

Your Contact Information

Full Name: *

Email Address: *

Phone Number: * xxx-xxx-xxxx

Department:

Cornell Affiliation:

Undergraduate Student

Graduate Student

Faculty

Staff

Session Information

What type of instruction would you like?: *

Class-related session

Workshop

Course web page

Library assignment

Special instruction session (for Cornell Cooperative Extension, emeriti, high school outreach, etc.)

Tour and/or Orientation

Consultation

(check all that apply)

Course Information:

(if applicable: abbreviation, number, title, meeting times, etc)

Number of Participants:

Explanation of instructional needs:

(including assignment or topic information if known)

Preferred date of session:

Second Preference:

Third Preference:

Comments:

Albert R. Mann Library