general_proposal

Contact Information:

First Name:

Last Name:

Mailing Address:

City:

State:

Zip:

Contact Phone Number:

Email:

Professional Website: (optional)

CLASS TITLE or SUBJECT:

PREFERRED CLASS LENGTH (check all that apply):

5 days 2 days 1 day 1/2 day

PREFERRED SEASON (check all that apply):

BRIEF DESCRIPTION OF PROPOSED CLASS:

OR attach class description as a separate document:

TO WHOM MIGHT THIS CLASS APPEAL?

IDENTIFY PLACES TO RECRUIT STUDENTS:

HOW WOULD YOU HELP US RECRUIT STUDENTS?

INSTRUCTOR WILL PROVIDE:

STUDENT WILL PROVIDE:

THE CLEARING WILL PROVIDE:

PROPOSED FIELD TRIPS OR SPECIAL ACTIVITIES:

HAVE YOU TAUGHT AT THE CLEARING BEFORE?

No Yes

WHICH CLASS(ES) DID YOU TEACH?

OTHER RELEVANT TEACHING EXPERIENCE:

EDUCATIONAL BACKGROUND:

REASONS FOR WANTING TO TEACH AT THE CLEARING:

COMMENTS: