Indicates Required Field
 
Full name
 
 
Department
 
 
Email
 
Note: A copy of this form will be emailed to this address upon completion.
Send me this email as HTML instead of plain text.
 
Telephone
 
 
Course name
 
 
Course number
 
 
Course meeting day and time
 
 
Course location
 
 
Number of students
 
 
Will you provide a computer and LCD projector?
 
 
What type of workshop are you requesting?
 
 
Proposed date for an ALC staff member to come to your class (with most preferred listed first)
 
 
Thanks for your request.