COMMUNITY EDUCATION - COURSE PROPOSAL

Today's date
Proposed title
Course description (brief; less than 40 words)

Instructor name
Address
City Alabama Alaska Arizona Arkansas California Colorado Connectucut District of Columbia Florida Georgia Hawaii Illinois Indiana Iowa Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New York North Carolina Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconson Zip
Day telephone Night telephone
Alternate telephone email
Please provide a brief description of your experience and/or background related to instructing this course.

Proposed start date end date
Inclusive dates
Day(s) of the week Mon Tue Wed Thu Fri Sat Sun
Total number of sessions
Proposed start time AM PM       End time AM PM
Number of students: maximum minimum

Room requirements
Classroom with desks
Tables and chairs
Computer lab
LCD projector
Other
Location
On Parkland campus
Off campus
IETC (Former K's Merchandise)
Robeson Hall (downtown Champaign)
Bauman Center (across from Schnuck's)
Other

Please indicate what supplies might be needed and the approximate cost
price will be included in student fee, unless otherwise noted
Item             Item
Number             Number
Cost             Cost
Total             Total

Are students required to purchase additional supplies at own expense Yes   No

Approximate Cost
Please provide a list, this will be sent prior to start of class

Textbook required    Yes   No price will be included in student fee, unless otherwise noted
Approximate Cost
Ordering information

Have you received a paycheck from Parkland in the past three (3) years?    Yes   No
* if you have not, you will need to complete an application and show proper identification to be placed on the payroll.   An application will be sent in the future.

Optional:
Suggested student fee for this course
Parkland College Community Education is a cost recovery program, therefore our goal is to provide a reasonable price to the student AND meet our program expenses.

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