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Teaching Request for Community Education
Community Education
Community Education
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Teaching Request for Community Education
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Phone
*
Email
*
Email
Confirm Email
Course Information
Semester
*
Fall
Spring
Summer
Course Name
*
Course Description
*
Location
*
Begin Date
*
Day(s) of the Week
*
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Begin Time
*
End Time
*
Number of Meetings
*
End Date
*
Max Enrollment
*
Cost of Materials-To be Paid to the Instructor
Guest Speakers/Agencies
Will you have a guest speaker or agency?
*
Yes
No
Guest Speaker Name
First
Last
Contribution to the Class
Phone
Email
Email
Confirm Email
Agency
Contribution to the Class
Contact Name
First
Last
Phone
Email
Email
Confirm Email
Instructional Supplies-These items will be calculated into the course fee.
Do you require instructional supplies?
*
Yes
No
Vendor
Phone
Website
Item Description
Item #
Quantity
Unit Cost
Vendor 2
Phone
Website
Item Description
Item #
Quantity
Unit Cost
Vendor 3
Phone
Website
Item Description
Item #
Quantity
Unit Cost
Sponsorships
Do you have sponsorship(s)?
*
Yes
No
Sponsor Company
Contact Person
First
Last
Phone
Email
Email
Confirm Email
Description of Sponsorship
Amount Pledged
Sponsor Company 2
Contact Person
First
Last
Phone
Email
Email
Confirm Email
Description of Sponsorship
Amount Pledged
Submit