Instructor name:
Phone:
Email:
Course number:
Course name:
  
Session location:
Campus:
Room:
SMART Classroom?:
Preferred instruction Dates/Time: (Select at least two choices)
First choice:

Time:
Second choice:

Time:
Third choice:

Time:
Session content: (Click on the links to see descriptions)







Additional notes:

Attach class assignment: (Required and must be in Word format)