Personal and Professional Enrichment Classes - Instructor Proposal

Complete one proposal form for each class. Please email course outline to brenda.helms@svcc.edu. In the subject line please include the name of the course.

Please don't fill out this input box.

First Name*

Last Name*

Sauk ID@12345678

Street Address*

City*

State*

Zip*

Home Phone

Work Phone

Cell Phone

Email Address

How do you want to teach the class?

Online

On-Campus

Check One or Both

If you want to teach Online, what online format or program will you be using?

Title of Course

Course Description

If you want to teach the course off-campus, please include the name & address of location:

What is the minimum age of a student can be to enroll into this class?

What is the maximum number of students for this class?

Select the day you prefer to teach

How many weeks will your class meet?

Preferred Date (1st Choice)

Preferred Date (2nd Choice)

Proposed Time - 1st Choice

Proposed Time - 2nd Choice

Textbook, if RequiredTitle, Author, Copyright Date, Edition, Publisher, ISBN#

Supplies Students Need To Bring

Instructor Supplies

Please mail, email or drop off handouts that you need copied for class at least one week before the start date.

Equipment Needed

Overhead Projector

Computer

Flip Chart

Video / TV

Computer Projector

Please select what your will need in your classroom

Other Equipment

Special Concerns or Comments