Program/Class Proposal Form - Instructor - IASC Community Education

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Program/Class Proposal Form

Are you interested in becoming a Community Education Instructor? Do you have a class proposal? If so please complete this form. Instructors will be notified once their class proposal has been accepted.

Class Proposal Due Dates:

Fall Catalog – Proposals Due by the 2^nd week in June
Winter/Spring Catalog – Proposals Due by the 1^st week in November
Itasca Networks for Youth Guide – Proposals Due by February 1^st


Instructor Information

Instructors First Name:	*

Instructors Last Name:	*

Email:	*

Address:	*

Address:

City:	*

Zip:	*

State:	*

Phone:	*

Cell Phone:

What district would you like to teach at?	*

* I am a current district employee:
		Yes
		No

If you are working with Youth, have you completed a background check with the district?
		Yes
		No



Class/Program Information

Course Title	*

Course Description (keep short, approximately 30-45 words):	*

Day(s):	*

Date(s):	*

Time:	*

Class Location (if you would like to use a school facility for this class/program type in "Request School Facility"):	*

Minimum # of Participants:	*

Maximum # of Participants:	*

Minimum Age Requirement:

Maximum Age Requirement:

Suggested Course Fee:	*

Materials Fee (if any):

Supplies Participant must bring to class:

Registration Information:

Registration Deadline:	*

Other Information:

Do you have a photo to describe this course? If yes please email it to
		Yes
		No

Send a copy of the completed form to this email address :

* Indicates Required fields.

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