NON-CREDIT CLASS PROPOSAL for 2018
Submit a separate proposal for each class.
2018 class proposals Name: _______________________________________________ Social Security Number: _____________________ Address: _______________________________________ City_______________ State _____ Zip Code ___________ Phone: Cell_________________________ Home_________________________ Work ________________________ Email: _________________________________________________________________________________________ ***Additional HR paperwork requirements will be issued upon contract assignment.
Proposed Title/Subject: ___________________________________________________________________________________ Provide a class description including at least three objectives, and specify what will a student know or accomplish upon completion of this class? (write on back page if needed) _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Special instructions or supplies required by students for class to include in course description: No Yes, please specify _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Supplies or manuals provided to the students with additional supply fee paid directly to you: No Yes, please specify $________ per student for the following supplies Pre-approval required. _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ ►Preferred campus:
Beardstown
Hillsboro
Jacksonville
Litchfield
►Number of students per class: minimum capacity __________ ►Preferred student type:
Adults (ages 19 & over)
►Sessions per class:
1 day only
Springfield
Taylorville
maximum capacity ______________ Youth (ages 18 & under)
Weekly Session
Combined
Number of weeks ______________
►Preferred day of the week (M – SU):
Primary: _____________________
Alternate: _____________________
►Preferred class times (a.m./p.m.):
Primary: _____________________
Alternate: _____________________
►Preferred meeting room type:
classroom
►Specific classroom needs:
table
computer lab desk
other ______________________________
open space
sink
other _______________
►IT/Resource needs: minimum of at least two to four-weeks advance notice REQUIRED; late requests are not guaranteed dry erase board computer Internet access projection screen other _______________ ►Textbook/Supply information: To ensure delivery, LLCC bookstore requires a minimum of 4 weeks advance notice. Required ____________________________________________________________________________________________ Title
ISBN# (if known)
Please return to: Community Education, Lincoln Land Community College 5250 Shepherd Rd., Springfield, IL 62794-9256 For more details, contact Laurel Bretz, Director of Community Education (217) 786-2430
[email protected] Jessica Ingold, Coordinator of Youth Enrichment Services (217) 786-4905
[email protected] Community Education is a self-sustaining program of LLCC. Do not write in this area, for office use only:
Accept/Decline IT Request Book Order Supplies
