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Classroom Instruction Request Form - for Faculty

This form is designed for classroom instructors. Students who need individual assignment or research needs may ask for help at the reference desk, or call (270)809-2053 (Toll-free 1-866-774-6612) during the library's open hours.

Selection aids for instructors:

To insure that your request is answered adequately and in a timely fashion, please schedule presentations as early as possible. Scheduling at least one week in advance is optimal.

You should plan on attending the session with your students. Library instruction sessions are more meaningful and effective when the instructor attends and participates.

Please complete form as fully as possible. Asterisks (*) denote require fields.

Instructor and Course Information

Your name* Your email address*

Phone extension*

Your department*

Course alphanumeric designation, i.e. EDU 120*

Course title

Classroom location*

Please indicate on which campus the course is taught:

Murray Paducah Hopkinsville Ft. Campbell Henderson Madisonville

Number of students enrolled*

Do any students in your class have special needs ? Yes No
If "yes", please specify:

Course meeting days: * Monday Tuesday Wednesday Thursday Friday Saturday

Time course meets*

Session Preferences

Please provide at least two preferences for the day/date and beginning and ending times for your library instruction session. This will help us plan the session that best meets your requests.

First Choice*
Day and Date Beginning Time Ending Time

Second Choice*
Day and Date Beginning Time Ending Time

Third Choice
Day and Date Beginning Time Ending Time

My classroom is laboratory-style, with computers available for student use. Yes No

This class is taught using the following: ITV Blackboard Web-based None of these

Learning activities requested for the session (check all that apply)*

Tour of library facilities
General instruction on the library catalog and multidisciplinary databases
Discipline-based instruction (no specific assignment involved; majors or graduates)
Assignment-based instruction (You will be asked to provide a copy of your assignment.)

Would you prefer the presentation be in your classroom, or in the library itself? Classroom Library

Is there a specific librarian with whom you have worked, and would prefer as a presentation leader?

Do you want time set aside for students to work on their assignment in this class period?. Yes No

Do you want the librarian to remain and assist students with their research in this class period? Yes No

Please share any additional information:

Submit Clear


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