First name:

Last name:

Email address:

Extension (or phone number where you can be contacted):

Course name:

Course number (i.e. ENG102):

Number of students in the class:

Where is this course given?
  West Windsor Campus
  James Kerney Campus
  Dempster Fire Training Center

Is this class regularly scheduled in a classroom with computers for every student? No
Yes
If yes, what is the room number (i.e. AD233)?

	Preferred date mm/dd/yy	Preferred start time hh:mm am/pm	Preferred end time hh:mm am/pm
1st choice		AM     PM	AM     PM
2nd choice		AM     PM	AM     PM

Type of instruction you are requesting:
 Library Tour (what's this?)
 General Orientation (what's this?)
 Subject Orientation (what's this?)
 Reference Assistance (what's this?)

NOTE: Only library tours and reference assistance are given in the library. All other orientations are normally given in a computer classroom elsewhere on campus. The library secretary or other member of the library staff will contact you with your room assignment.

Please describe the writing or research assignment your students will be given in conjunction with this IL class as well as any topics and/or specific resources you would like covered. Also, please send a copy of the syllabus/assignment to the library secretary or email it to: library@mccc.edu.

Please supply any other information that would help the library staff to prepare for this session.

If you have any other questions, please contact the library secretary at ext. 3545 or email to: library@mccc.edu.