2. This Course Proposal should represent the Instructor’s ‘ideal’ and is intended as a starting place for discussion between the Recreation Department and the Course Instructor. As such, final details may vary from what is initially proposed.
4. DEADLINE for submission of SUMMER, 2018 Course Proposals is: MARCH 1, 2018
6. Business Name
7. Instructor's name*
9. Mailing Address*
11. Telephone 1*
12. Telephone 2
14. Email Address*
15. Preferred Contact Method*

    1. Telephone 1
    2. Telephone 2
    3. Email
19. Bilingual Course(s) Offered?*

    1. Yes
    2. No
20. Minimum Required Participants*
21. Maximum Total Participants*
23. General Description of Course(s) (include sections or levels of class)*
25. Please fill in the Course Details Below, for up to Four Courses
27. Course Name
28. Course Name
29. Course Name
30. Course Name
32. Day of the Week
33. Day of the Week
34. Day of the Week
35. Day of the Week
37. Time
38. Time
39. Time
40. Time
42. Date Range
43. Date Range
44. Date Range
45. Date Range
47. Omit Dates
48. Omit Dates
49. Omit Dates
50. Omit Dates
52. Age Range
53. Age Range
54. Age Range
55. Age Range
57. Number of Classes
58. Number of Classes
59. Number of Classes
60. Number of Classes
64. Instructor Fees $*
65. Plus 30% Recreation Division Fee =
66. Total Course Fee Per Student $*
68. Student Lab Fee (if applicable) $
69. (Please note: the Recreation Division fee of 30% is charged in addition to Instructor Fees. Also, an additional Facility Charge for storage of instructor equipment may be added as needed)
73. DEADLINE for submission of Winter, 2018 Course Proposals is: NOVEMBER 6, 2017
75. Instructors MUST provide the following documents BEFORE courses begin:
77. Certificate of Insurance (verify Certificate is current before submission)
78. Mandatory Reporting Form
79. Live Scan Fingerprints / Background Check
81. TB Test Affidavit (within the last two years)
82. IRS Form W9
Leave This Blank:


86. 1. Receive an email copy of this form.
87. Email address

    This field is not part of the form submission.

88. Submit

* indicates a required field