Continuing Education
Credit-Free Course Proposal
Complete this form (one form per course) and mail to the following: For Credit-Free Programs: Stephen Campiglio, MS #16, P.O. Box 1046, Manchester,
For Computer Programs: Bruce Manning, MS #16 P.O. Box 1046, Manchester, CT CT 06045-1046; fax to 860-512-2801 or email to scampiglio@manchestercc.edu.
06045-1046; fax to 860-512-2801or email bmanning@manchestercc.edu.
For more information, contact Stephen Campiglio by email or call 860-512-2824.
INSTRUCTOR INFORMATION
First Name MI Last Name Date
Street Address Apt. No.
City State Zip
Home Phone Work Phone Cell Phone
Email Are you a Connecticut state employee?
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Yes
n
No
Can students contact you directly?
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Yes If yes, please check all that apply.
n
Day Phone
n
Evening Phone
n
No
SCHEDULING INFORMATION
n
Email
Available to Teach (check all that apply)
n
Mornings
n
Afternoons
n
Evenings
Days Available to Teach (check all that apply)
n
Monday
n
Tuesday
n
Wednesday
n
Thursday
n
Friday
n
Saturday
n
Sunday
Please tell us if there is an ideal class size and why. Also, tell us if there is a maximum class size and why.
Number of Meetings Length of Each Meeting Time Preferred Total Hours
Preferred Dates Second Choice Dates (for scheduling flexibility)
Location: Willing to Teach at (please check all that apply)
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MCC
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Own Facility (requires certificate of liability)
If own facility, please supply business name and address
CLASSROOM NEEDS/EQUIPMENT
Which would you prefer?
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Desks
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Tables What type of flooring do you prefer?
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Carpet
Do you need an open space for movement activities? Do you need a sink?
Do you need computers for all students?
Any other special accommodations or needs? Please explain.
Do you need a computer for the instructor?
Do you need a projector?
n
Yes
n
No
Do you need a CD player?
Type of computers required?
Software needs, please specify ________________________________
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Tile
n
No
n
No
n
Yes
n
No
n
Yes
n
Yes
n
Yes
n
No
n
No
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PC
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Yes
n
Mac
OFFICE USE ONLY
Subject Category for Print Catalog _____________ Subject Category for Banner/Online:___________ Number Grade Required? _______________
March 2019/PR
COURSE INFORMATION
New courses must include a course outline/syllabus with learning objectives. MCC reserves the right to edit the course description and/or instructor biography.
Course Title
Is this a
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New Course
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Existing Course
Course Description: For new courses, provide 60-100 word description that includes who the audience is, what they will learn, and how they will learn it. For existing
courses, please provide revised description or indicate below “No changes”.
Instructor Biography: For new instructors, provide 30-40 words about yourself, highlighting your personal experience as it directly relates to the course. Include your
credentials, such as college degrees, licenses held or certification that qualifies you to teach the course (attach copies of your credentials to this course proposal). For
returning instructors, please provide updated instructor biography or indicate below “No changes.
Indicate audience or potential market that would be interested in this course.
Course Title
How can we best market this course?
Required Text: Please do not use a required text unless absolutely necessary. We will order any “required” textbooks from the MCC Bookstore. If you’d like, you may
suggest a “recommended” text in your course description, but these texts cannot be ordered through the MCC Bookstore; students are advised to shop for them at their
local bookstores. If your text is recommended, please do not complete this section, but rather note the title and author in the course description.
Title Author(s)
Publisher ISBN # Price
Materials Fee: The course fee (tuition) and your compensation for teaching
(stipend/salary) are not the materials fee. Students pay the course fee directly to
the college, the college pays instructors to teach, and some instructors provide
materials to students for an additional fee. This fee is paid directly to the instructor
by the student, usually at the first class. A materials fee cannot be charged to
students unless: A) it has been discussed with the director and B) it has been
listed in the catalog course description.
If you have already consulted with the director regarding your need to
charge a materials fee, please estimate the dollar amount (per student) that
would be payable to you by the students for supplies that you will be providing to
them for their personal use (i.e., art kits, specialized equipment, film, etc.).
Handouts: Please include the handouts for this course (if any). Be aware that
most published materials have copyright restrictions.You may place items on
reserve in the library for students to access.
Pre-class Happenings: Are there any preliminary steps for your students prior
to class start (questionnaires, supply lists, reading, etc.)? If so, please attach your
instructions, and we will mail the information to your students. It is important
to note that many students register at the last moment and therefore may not
receive the necessary information. Please plan accordingly.
Prerequisites: Credit-free courses generally do not have prerequisites, which
reduce the number of potential students. However, if there are prerequisites,
please state:
is a per student fee and will be published in the
catalog.
Note: If you are buying in bulk, please provide us with the total amount that you
will need to collect from the group in order to cover materials.
$
$
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