CREDIT Classroom Assistance Request Form

Faculty Name:

Course:

Section # (required):

Room 1:

Room 2:

Email:

Campus:

Semester:

I would like assistance every week
Days that you would like assistance:






Start Time:

End Time:


Preferred number of consultants:

OR

I would like assistance on workshop days or these dates only

Date you'd like assistance (#1):

Date you'd like assistance (#2):

Date you'd like assistance (#3):

Date you'd like assistance (#4):

Start Time:

End Time:


Preferred number of consultants:

Please include any additional comments or details about your request:

Please indicate when you would like this assistance to begin:

Preferred writing consultant (if you have one or more):

Please briefly indicate what you will be asking your writing consultant to do in class.
This information is optional, but it helps us match the best writing consultant with your class’s needs.
You may request a WIN session here as well.


In order to help us prevent SPAM, please enter the number before submitting the form.