CONTINUING EDUCATION
NON-CREDIT PROGRAM PROPOSAL FORM
Instructor Information:
Instructor Name:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Phone:
Fax:
Email:
Course Information:
Course Title:
Course Description:
Course Outline:
Home
Cell
Work
Target Audience:
Minimum Age Requirement?
Total Course Hours:
Will CEUs be awarde? Yes No
Maximum Number of Students:
When would you like to offer this class?
Daytime (between 8:00 am 5:00 pm):
Evenings (between 5:00 pm 9:30 pm):
If your course meets the criteria for current industry demands, we will contact you to obtain
specific dates you are available to teach based upon your preference indicated above.
Will you need any special equipment?
Computer/Projector/Screen for presentation
Computers for students
Will you be using a textbook? Yes No
Name of Textbook:
Publisher:
Edition or Date:
ISBN Number:
Are any specific supplies needed per person?