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Library Lecture Request
Instructor:* Department:*
Extension No. : 
        (e.g. 25600)
or Home / Cell Phone:
(e.g. 714-626-2230) 
Course Name & Number:* Section No.:
Course Title (If Relevant): Number of Students:*
Date requested*
     (e.g. 11/22/2008)
Alternate date:
(e.g. 11/22/2008) 
Time requested*
              (e.g. 11:00)
  Alternate time:
(e.g. 01:00) 

Type of Lecture          
Specialized (please explain):
On Topic(s):
To Include:
Specific Resources
Citation Style:                        
Other (please specify)
Other (please specify)