Course-Integrated or Senior/Advanced Module Request

Please allow a minimum of two weeks between your request date and the time period in which you hope to have a module scheduled. Questions? Please contact the Library Instruction Coordinator, Beth Hillemann (or x6704).

Your Name

Your Department or Program

Office Phone

Email Address

Course Number and Name

Course Meeting Days and Times

Number of Students in Class

Level of Students in the Class

(Check All That Apply)

First Years




I Would Like to Sign Up for One or More of the Following

Course-Integrated Modules

Library Research

Managing Information & Using RefWorks

Scholarly Communication & Intellectual Property

Software Applications

Senior or Advanced Seminar Module

Library Research

Presentation Preparation (Software & Technology)

Preferred Dates/Times for Instruction Session(s)

(Please List 3 Options)


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