In-Class Workshop Request Form

Instructor Title
Instructor Name Instructor Name First Last
Instructor Email
Course Code and Number
Course Title
Course Meeting Dates and Times
Location
Course Enrollment

Because workshops are highly interactive, special arrangements will be necessary for groups of more than 35 students.
First Choice Visit Date First Choice Visit Date / MM / DD YYYY

Please schedule your classroom visit at least two weeks prior to your desired visit date. It is also a requirement that you be present for the workshop.
Second Choice Visit Date Second Choice Visit Date / MM / DD YYYY
Time at which you would like the visit to begin Time at which you would like the visit to begin : HH MM AM/PM
Type of Workshop Requested
Comments