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Community Education Course Proposal

Instructor Information

Name:

Street Address:

City:   

State:   

Zip:

     Daytime Phone #:   

Cell #:   

Email:

Information about the instructor for advertising and brochure Purposes (Degrees, Honors, Etc.):

   

Proposed Course

Class Title:

Brief outline of Course:

Preferred Location(s):

(El Dorado, Andover, Rose Hill or Butler Service Center)

# of Sessions Needed for Course:

Days & Dates of Class:

Beginning and Ending Time of Class Sesions:

Minimum & Maximum Number of Students:

Min: Max:

Course Specifics

Classroom and/or A/V Requirements:

Materials to be purchased or supplied by BCC:

(if you require materials from BCC they will be purchased before the class begins and will be distributed to you - these costs will be figured into the cost of the class)

Materials, etc, Students should bring to first session and their approximate cost:

Payment Information

REQUIRED PAYMENT FOR SERVICES per student per hour Note $5.00 will be added to this amount creating the student charge