Library Take Out Request Form Contact Ingrid Ruffin, email: firstname.lastname@example.org or phone: (865)974-3513 if you have any questions. Please make request at least two weeks before expected event. ***Please try to schedule programs for Tuesdays and Thursdays, but accommodations can be made for other times when appropriate*** Name* First Last Residence Hall*Email Address* Status*Resident AssistantHall DirectorGraduate AssistantAre you an RA for a Living Learning CommunityYesNoProgram Type*Library Instruction (Topics can include, but are not limited to overview of online services, citing sources, advanced database searching, and acclimation to the research environment )Residence Life Research Support (Topics can include, but are not limited to one-to-one assistance, the research process, small group assistance, and presenting your research)Civility in Action (Topics can include, but are not limited to Community Conversations, hot topic discussions, movie discussions, and book discussions)You are a Grown-up, Now What? (Topics can include, but are not limited to information literacy, political literacy, media literacy, and technology literacy)Other (Please specify below.)If you chose \"other\" above, what is your program idea?Preferred date for program* Second choice for date of program* Third Choice for date of program* Preferred Start Time* : HH MM AM PM Second Choice Start Time* : HH MM AM PM Time limit for presentationNotes and Special InstructionsNameThis field is for validation purposes and should be left unchanged.