Don't Cancel That Class Request Form

Question Title

* 1. What is your first and last name?

Question Title

* 2. At what email address would you like to be contacted?

Question Title

* 3. What is the class title and course code you would like covered?

Question Title

* 4. What day would you like the class covered?
*10 days advanced noticed required.

Date

Question Title

* 5. How long is the class?

Class start time

Time

AM/PM

Class end time

Time

AM/PM

Question Title

* 6. How many students are in the class?

Question Title

* 7. Would you like us to take attendance?

Yes

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* 8. Where is the class located? Building and room number required.

Question Title

* 9. Is the classroom equipped for audio/visual? If so, please arrange assistance with set up.

Yes

Question Title

* 10. What topics would you most like your students to learn about or discuss?

Question Title

* 11. Are you requesting coverage of multiple sections of the same course? If so, please list additional class dates/times/number of students below.

*Please complete an additional form if you would like coverage for additional courses.

Don't Cancel That Class Request Form

Question Title

* 1. What is your first and last name?

Question Title

* 2. At what email address would you like to be contacted?

Question Title

* 3. What is the class title and course code you would like covered?

Question Title

* 4. What day would you like the class covered? *10 days advanced noticed required.

Question Title

* 5. How long is the class?

Question Title

* 6. How many students are in the class?

Question Title

* 7. Would you like us to take attendance?

Question Title

* 8. Where is the class located? Building and room number required.

Question Title

* 9. Is the classroom equipped for audio/visual? If so, please arrange assistance with set up.

Question Title

* 10. What topics would you most like your students to learn about or discuss?

Question Title

* 11. Are you requesting coverage of multiple sections of the same course? If so, please list additional class dates/times/number of students below. *Please complete an additional form if you would like coverage for additional courses.

* 4. What day would you like the class covered?
*10 days advanced noticed required.

* 11. Are you requesting coverage of multiple sections of the same course? If so, please list additional class dates/times/number of students below.

*Please complete an additional form if you would like coverage for additional courses.