This request form must be submitted two weeks in advance.
A librarian will contact you to confirm your request and our availability.

Instructor Name (Required):
Course Number :
Course Title (Required):
Date of Instruction Session (Required):
Date of Instruction Session - Second Choice (Required):
Time of Instruction Session (Required):
Preferred Location of Instruction Session: (Note: Internet Access is Required) Library Portland Classroom Room Number Gorham Classroom Room Number LAC Classroom Room Number Other Physical Location     Online (Blackboard, Elluminate, Other)
Instructors Email (Required):
Instructors Phone (USM campus ext.):
Phone (Home/Other):
Number of students in class:

Assignment and date due:

Sources/Topics to be covered:

Other comments: