Quarter Spring Summer Fall Winter Year 2005 2006 2007 2008
Department and Course:

Please select all that apply:

Monday Tuesday Wednesday Thursday Friday
Saturday Sunday

Hours: ( i.e. 2:00 pm - 4:00 pm)

Same hours every day? Yes No

If no, please list the days and their respective hours below:

Anticipated Number of Students:

Classroom Requirements:

Anticipated Housing Requirements:

Housing Request Form

Other Resources Needed:

Microscope Requirements Yes No

Dissecting: Compound:

Will bring own equipment:

Chemicals/glassware:

Analytical or other instruments:

Small Boat Requirements:

Animal Collection or Maintenance:

Audiovisual Requirements:

Library Requirements

Library Orientation for Students: Yes No

Library Reserves

Other Library Resource Requirements:

Other Requirements

Contact Information