NOTE: This form is simply a guide and should not limit the type of instruction needed by your students. Every effort is made to tailor the instruction to the specific information needs and level of the class.

Last Name (REQUIRED):


First Name (REQUIRED):

E-mail (REQUIRED):

Classification (REQUIRED):
Choose One Freshman Sophomore Junior Senior Graduate Faculty Staff Other (specify in comments below)

Office/Day Phone (REQUIRED):


Department (REQUIRED):

Class Code/Number [ex.: LSIS 5451] :


Class Name/Title [ex.: Intro To Databases] (REQUIRED):

Number In Class (REQUIRED):

Date/Time Needed By (REQUIRED)
[Please enter as mm-dd-yyyy 00:00 AM or PM]:

Indicate the type of Library Instruction you require by checking all that apply
(from the list below):
General Library Tour/Orientation Instruction
Online Catalog Instruction
Electronic Databases Instruction
Printed Indexes Instruction
Instruction for a specific assignment (Please provide assignment details via Comments box below.)
Others (Please provide details via Comments box below.)

Web address (URL) of online class syllabus or course outline:
or...

Please provide assignment details or list research topics students are working on:

List any specific keywords or topics being researched in this class:

Special requirements or considerations:
(Explain below any specific needs or areas that should be
given special consideration or emphasis, e.g. hands-on)

COMMENTS
Enter any additional appropriate details, suggestions and comments below:

Hafsa Murad, Information Literacy/Library Instruction Librarian
c/o James E. Shepard Memorial Library Room 224
North Carolina Central University
Tel. (919) 530-7315
Fax (919) 530-6187
E-mail: hmurad@nccu.edu