TRANSFER SERVICES
CLASSROOM VISIT REQUEST FORM
With the exception of the comments field, all fields are required!
Faculty/Staff Name:
Phone:
Email: @qcc.mass.edu
Office:
   
Course Title:
Course Number & Section:
Room Number:
Building:
Number of Students:
Is there Media Access in the Class or Meeting room?

CPU and LCD projector?  Yes   No
Internet Access?  Yes   No

IF YOU SELECTED NO, please click:  Media-Services to request the CPU\LCD and Internet access.

   
Visit Request Date Information (select as indicated):
First-Choice-Date:
Day of Week:
Time of Day:
   
Please check only if there are no possible "Second Choice Dates" and leave the second choice fields as they are.
Second-Choice-Date:
Day of Week:
Time of Day:

Presentation choice (Indicate any specifics) - please choose one.

50 minutes – includes overview of Transfer Services, Transfer Programs and related issues.  Orientation and the practical use of the Transfer office website with Q & A.

15 minutes – includes a brief overview of Transfer office, services and programs. Includes a brochure with information for accessing transfer resources.

 

Please check-off to affirm that you understand Faculty/Staff must be in attendance during the presentation.

 

Additional Comments:

 

Please note that all requests are subject to availability.  Transfer Services will contact you to confirm the visit and to discuss any issues.   You will receive a form submission confirmation email shortly after submitting this form.
 

Thank You!