Library Workshop Request Form

First and Last Name (required):
Email Address (required):
How may I contact you?
(Please specify a phone number where you can be reached.)
Course Name & Number:
Class Size:
Preferred Date and Time:
1st Choice:

2nd Choice:
Preferred Location:





Please describe the research assignment. Be sure to include the types of resources you would like to include during the instruction session. If possible, send a copy of the syllabus or assignment to breua@uhv.edu.
Please describe any special accommodations that will be needed for the instruction session.
Please type the two words shown in the image. (required)

If the letters are too hard to read. Please select the REFRESH buttonrefresh button, found in this image.