Form

INSTRUCTION REQUEST FORM
Today's Date *

Month Day Year
Instruction Request by: *

First Name Last Name
E-mail *
Phone Number

- Area Code Phone Number
Affiliation *
Affiliation, if other
Department
Course Number
Course Title/Purpose
When would you like to meet?

Sessions normally range from 60 min to 90 min
Date and time of instruction requested *

- Month - Day Year
at
: Hour Minutes
Alternate date option *

- Month - Day Year
at
: Hour Minutes
Number of participants *
Due to space we can accommodate up to 20 participants per session. However, we are willing to work with you in terms of space.
Where would you like instruction to take place?

Ethnic Studies Library Your Classroom
If not in the Ethnic Studies Library, where is your classroom located?
If at the Ethnic Studies Library will you be attending instruction with your students?

Yes No
Help Us Help You
Library instruction is most relevant and productive when it accompanies a specific assignment. On the date of your library session, will your students be working on a particular assignment that requires them to use library resources?

Yes No
What would you like your session to focus on?

Tour of library and different collections. Finding sources (ex: academic, popular, primary) Library Assignment Subject-Specific Resource Training Evaluating Web Resources Specific database(s) Other
If other, please give us an idea of which important topics you would like us to cover
Attachments

Please attach a copy of your syllabus and/or assignment.
Syllabus
Must be in PDF format
Assignment
Must be in PDF format
** If your attachment file is too large please email it to: melissa.s.stoner@berkeley.edu after you submit your instruction request**
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

INSTRUCTION REQUEST FORM

When would you like to meet?

Help Us Help You

Attachments

** If your attachment file is too large please email it to: melissa.s.stoner@berkeley.edu after you submit your instruction request**

If your attachment file is too large please email it to: melissa.s.stoner@berkeley.edu after you submit your instruction request