| INSTRUCTOR INFORMATION |
| * Instructor's Name (Last, First): | |
| Office Location & Mail Stop: | |
| * E-Mail Address: | |
| Phone: | |
| COURSE INFORMATION |
| * Subject: | |
| * Course Name: | |
| * Semester/Year: | |
| * Course and Section Number: | |
| Number of Students: | |
| Course website address (optional): | |
| Web based course: Yes No |
| Permission to link to page: Yes No |
| Password protect personal items: Yes No |
| Return Materials by Campus Mail: Yes No |
| ITEM INFORMATION |
**YOU MAY SUBMIT A READING LIST WITH COMPLETE CITATIONS IN LIEU OF THE FOLLOWING.
(You will still need to indicate the LENDING INFO (& PAST USE, if copies) for
each item. Send reading list via email or deliver to office.**
|
| * Title (as listed on your syllabus): | |
| * Author or Editor: | |
| * Date or Edition: | |
| Full citation (for copies only): | |
| Past Use (for copies only): |
|
| LENDING INFORMATION |
| Format: | |
| Lending Period: |
|
| Duration: |
|
| Source of Item: | |
|
|
|
