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Internet Instruction Request Form
Instructor:
Phone:
Email:
Department:
Course Number:
Course Name:
DAY of Session: Mon
Tues
Weds
Thurs
Fri
DATE of Session:
TIME of Session:
TYPE of Session:
Basic
Advanced
Number of Students:
Objective of Session:
Resources to be included
:
Library Worksheet:
Yes
No
Additional Notes:
