Ossining Extension Center - Student Service Request Form

Dear Ossining Extension Center Faculty Member:

If you are interested in any of the following services, please fill out this form and place it in the faculty drop box in the front office area. I will contact you to set up the service for you or your class. If you have any questions, feel free to call me at 914-606-7409 or email at nicole.joseph@sunywcc.edu.

Academic Training

Discipline:
Day and Time:	This requires a minimum level of commitment from your class to ensure participation.

Career Counseling
Day and Time:
Specify area of interest:

Library Instruction
Faculty Instruction only or Class Instruction (may require use of the computer lab)
Day and Time:

Professor's Name:
Course Name/Day/Time:
Contact Number: