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Proposal Form for a LIFE Class or Trip
* indicates required field(s).
Program Information
* Program Title:
* Semeter:
Select One
Winter/Spring (Jan-May)
Summer/Fall (Aug-Dec)
* Year:
Select One
2008
2009
2010
2011
2012
* Number of Sessions:
Select One
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
* Length of Sessions
Select One
30 Minutes
1 hour
1.5 hours
2 hours
2.5 hours
3 hours
3.5 hours
4 hours
4.5 hours
5 hours
5.5 hours
6 hours
6.5 hours
7 hours
7.5 hours
8 hours
* Description for Program Guide (2-3 sentences):
Scheduling Preference
* Time of Day:
Select One
Morning
Afternoon
Evening
Anytime
* Day:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
* Month(s):
January
February
March
April
May
June
July
August
September
October
November
December
Presenter Information
Presenter(s) Name:
Address:
City:
State:
Zip / Postal Code:
Phone:
Email:
Special Events Only
Trip Leader:
Meeting Location:
CarPool
Ticket Purchasing
Group Lunch
Group Lunch Restaurant:
Group Dinner
Group Dinner Restaurant:
Equipment/Arrangements Needed
CD/Cassette
Computer
Data Projector
DVD Player
Internet Connection
Overhead Projector
VCR
Other:
Room Preference:
Proposed By
Proposed By:
Phone:
Email:
Curriculum Committee Contact
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Proposal Form for a LIFE Class or Trip