Instruction Request Form: Contact Information

Now we just need some basic information from you, and we'll be in touch!

We ask that you request a session at least one week in advance; you will receive a confirmation usually within 24 hours of its receipt.

* (Required fields)
University Course Title: *
Course Number: *
Class Days & Time: * (M/W, T/Th, etc., include a.m. or p.m.)
Class Size:
Suggested Dates (2 or more):
Instructor's Name: *
Instructor's E-mail Address: *
Confirm Instructor's E-mail Address: *

Contact Email (if different than above):
Daytime Phone: (include area code)

Sending . . .

Please try again later. Or send it to libwebsystems@umich.edu in your favorite email client.
Your message was: