Library Instruction Report Form

Library/Staff Instructor:
Date:
Start Time:
Ending Time:
Place of Instruction:

Course Integrated Library Instruction

Course Name:
Course Number:
Section Number:
Number of Students:
WIC Class:
Class Instructor:
Phone:

Seminar/Workshop Instruction

Seminar/Workshop Name:
Number of Students:

Credit Class Instruction

Course Name:
Course Number:
Number of Sessions:
Number of Students:

Tours/Orientations

Number of Participants:
Class/Group/Program Name:
School K-12:

Note: Consult with the instructor about having class participants fill out evaluation forms at next regular class session.

If any attendees require handouts in accessible formats, such as Large Print - please contact JoLynn O'Hearn, 737-8226.