If you need to request a larger room or cancel/reschedule a session - please complete this form.

You will be notified as to the status of your request within 36 Hours

Last Name:

First Name:

Phone #:

E-mail Address:

SI Course/Section:

SI Professor:

Reason for Request:(Check all that apply)

Make-Up Session
Adding Extra Session
Size of Room is Inadequate
Cancel Session AND Reschedule - Reason for Cancellation:
Cancel Session Only - Reason for Cancellation:
Other:

New Room Request:

Date:

Day of Week:

Time:

Number Expected:

If Cancelling Session:

Date of Cancelled Session:

Day of Week of Cancelled Session:

Time of Cancelled Session:

Room of Cancelled Session:

How Would You Like to be Contacted?
By Phone
By E-mail

If you have any questions about completing this form e-mail Richard

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