Library Assistance/Instruction Request Form

Please complete the information below if you require individual or group assistance from a librarian. A librarian will contact you to confirm receipt of your request and your appointment date and time. Please contact librarycontact@wilmu.edu if you need to reschedule a confirmed appointment.

Your Information

Full Name:

E-Mail Address:

Contact Telephone Number:

Course Number & Title:

I am a(n):

Instructor Student

University Location:

ADA Accommodations Needed?

YesNo

If Yes, please specify.

This information will not be shared.

Type of assistance needed

Choose one:

Library Orientation

Library Assistance Session (One-on-One)

Desired session location:

In the Library

In a Classroom:

Phone

Online

Building & Room:

Number Of Students:

Desired Session Date/Time:

(Submit more than one choice – The Library Staff will attempt to accommodate your first choice)

	Date	Day of Week	Time
First Choice
Second Choice
Third Choice

Type of Instruction Desired

Check all that apply

Students Only

Have you declared a major?

YesNo

If Yes, what is your major?

What is your status?
(check one)

Undergraduate

Graduate

Doctoral

Other

Do you have a specific research topic?

YesNo

If Yes, what is your topic?