Fillable Clovis Community College - Community Service Class Proposal Form

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Clovis Community College - Community Service Class Proposal Form

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Return to: Al Potthoff, Clovis Community College, Allen.potthoff@clovis.edu, 575.769.4760
417 Schepps Blvd, Clovis, NM, 88101, Educational Services Room 151
Date:
Community Service
Community or Kids’ College Class Proposal
N
ame of person proposing class:
Instructor’s Name if different:
ADDRESS
HOME PHONE:
ALT PHONE:
e-mail address:
Title of Proposed Class:
Description of Class:
Best Meeting Days:
Best Meeting Hours:
Suggested Start Dates:
#
of Sessions: # in class hours:
Minimum Number of Students: _____________ Maximum Number of Students: _____________
Please describe the anticipated age group or other characteristics of the people this class is designed for:
Return to: Al Potthoff, Clovis Community College, Allen.potthoff@clovis.edu, 575.769.4760
417 Schepps Blvd, Clovis, NM, 88101, Educational Services Room 151
Special Room Needs:
Please list and describe any needed su
pplies as accurately as possible:
Please list any required Text book:
Title:
Author(s):
ISBN:
Notes & Comments:
Anticipate
d salary requirements:
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Clovis Community College - Community Service Class Proposal Form

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Completed 19 February 2020

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