|
Athletics and Recreation CRC 210, Olympia, WA 98505(360) 867-6770 Leisure Education Course Proposal Name: _________________________________ Course Title:__________________________ *New instructors-Please include a resume and course outline with
this proposal. Course fee: $_________________ Age range of paricipants:
________________ Please complete the following table with your choice of dates, times and places for your class.
If offering more than one section, please complete information for the section below
Please list the benefits students can expect from participating in
this course:
Instructor address: __________________________________ City: ____________________ State: ______ Home phone: ______________ Work phone: _____________ Business ID#, (if applicable)_______________ Email Address:_______________________ I give my permission for Evergreen, Leisure Education program, to release my phone number to persons inquiring about my course offering, and to participants registered in my course. Yes___No____ The numbers that may be released are: Home: ________________ Other: ________________ Will you need media equipment, such as a TV/VCR or overhead projector? Yes___ No____ Type of equipment__________________________ Dates equipment is needed__________________ |