This form is to be used by library staff conducting library instruction activities. It will be submitted to the Coordinator of Library Instruction for statistical purposes.
Name of librarian/staff conducting instructional activity:
Names of other librarians or staff involved in instructional activity:
Was this an ESU Class? Yes No
If yes, course number and name of course: If no, name of external group:
If no, name of external group:
Dates and times of session or sessions:
Number of students per session:
Type of session:
Number of sessions taught:
Location of instruction:
Library electronic classroom Another part of the library (Please explain) The instructor's classroom Other location (Please explain)
Another part of the library (Please explain)
The instructor's classroom
Other location (Please explain)
If "yes", please send the handout to the Library Instruction Coordinator either through an E-mail attachment or through campus mail. This is so it may be added to the library instruction files in the LEC.
Written primarily by you? Written primarily by the instructor? Written jointly by you and the instructor? Written by another librarian?
Written primarily by the instructor?
Written jointly by you and the instructor?
Written by another librarian?
Last Updated May 20, 2008
