Statistics Reporting Form

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Is there an additional Librarian?  Please add his or her name here.

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Type of Instruction (required)

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Title of Workshop, Outreach, or Course (if known)

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Academic Department (or N/A)

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Course Instructor (Last, First)

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Date of Session

Date

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Time of Session

Time

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Length of Session

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Time spent preparing

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Number of Students

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Location of Session

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Type of Class

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Please record anything else about the session that you would like to have noted for official/statistical purposes.

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