Name: _____________________________________________ Term: _____________________

Campus Address: _____________________________________ Campus Phone: _____________

Committees:__________________________________________ Home Phone:________________

Indicate below the hours for which you have firm commitments, or, alternatively, free spaces in your schedule. Add any additional schedule information at the bottom of the page in the space provided.

	Monday	Tuesday	Wednesday	Thursday	Friday
9.00–9.30
9.30–10.00
10.00–10.30
10.30–11.00
11.00–11.30
11.30–12.00
12.00–12.30
12.30–1.00
1.00–1.30
1.30–2.00
2.00–2.30
2.30–3.00
3.00–3.30
3.30–4.00
4.00–4.30
4.30–5.00
5.00–5.30
5.30–6.00

Comments: _________________________________________________________________________

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