Course Proposal Form
Highland Community College - Lifelong Learning
Proposed Course Title: Proposal Submitted By:
Address:
City:
State:
Zip Code:
Phone Number:
Select:
E-Mail Address:
Please complete all pages of this form and attach a current resume. The resume should include
your experience in the topic you are proposing for this course.
What is the expected outcome or objective for the student? (For example, at the end of the course,
the student will have completed a stained glass project).
Over the age of 18
Who is the target audience for this class? Select all that apply:
Under the age of 18
Are you able to assist Highland in promoting your
class?
Yes
(Proposed): Class Information
# of
Sessions:
Meeting Time:
Hours per
Session:
Start
Date:
End Date:
Day(s) of the week:
Minimum # of students:
Maximum # of students:
Suggested Registration Fee:
Supplies/Copy Fee:
Total Suggested Course Fee:
Desired Pay Per Hour:
# of Copies
Copy Preference:
Black/White
Color
Meeting Dates:
Meeting Location:
Course Description (in 50 words or less): (Lifelong Learning reserved the right to edit descriptions for
presentation and promotion purposed. Attach extra page if needed).
No
Describe materials and supplies (In fairness to students, material fees should be kept as minimal
as possible.)
Will students need to pay for supplies?
No
Material Fee Amount**:
Describe what Material Fees Are For:
Will materials be provided to students?
Yes
No
If so, estimated cost of materials:
Materials students must provide (ie. notebook, clothing):
Materials Instructor will provide:
Describe class activities (For example, session one overview, session two cut out pattern,
session three sew a blouse): (Lifelong Learning reserves the right to increase or decrease
sessions. Most classes run one to four sessions. Depending on subject matter, six or eight
sessions may apply).
If a textbook is required, please complete information below:
Title:
ISBN#:
Cost:
Describe room requirements (to ensure a suitable classroom is assigned and for schedule of media
delivery, please list media services and room requirements needed for your class). Requests
received after semester begins are subject to availability. For example, a projector, blackboard/
whiteboard, specific software, computer, tables, open space, mats, etc.:
**The Instructor is expected to ensure materials and supplies are in good condition. The
Instructor is expected to ensure students are aware of the safe use of materials and
supplies. Lifelong Learning requests an office copy of all handouts, books, etc. prior to
proposal approval and/or class start date.
PLEASE RETURN TO:
Highland Community College
Lifelong Learning (#37)
2998 W. Pearl City Road
Freeport, IL 61032
Phone: (815) 599-3403
Or return by FAX to:
(815) 599-3625
Yes