Library Instruction Request

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First Name *
Last Name *
Phone Number *
Email *
Course Title & Number *
Number of Students *
Preferred Date *
Preferred Time *
Preferred Location *
Room Number
Type of Instruction *
Additional Information
Type a number between 33 and 37 *
This form collects only the minimum amount of information necessary to provide the requested service. Information will not be used for secondary purposes or shared with third party users. The data in this form will be deleted after a period of two months or until the request is processed and statistical data is compiled for service evaluation purposes.
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