Form Center

Mailing Address

Brochure Edition (note session proposal deadlines)

Course Title

Course Description

Course description for activity guide, 25 words or less (leave blank if no revisions):

Special instructions for participants - prerequisites, clothing, supplies to bring to class, etc., 25 words or less (leave blank if no revisions):

Day(s) of week class held

Course Date and Time

Course Date and Time Start Date

Course Date and Time Start Time

—

Course Date and Time End Date

Course Date and Time End Time

No Class Dates

Make-Up Class Dates

Facility Requested (Choice 1)

DCC = Danville Community Center
OHP = Oak Hill Park Community Center
VMB = Veterans Memorial Building

Facility Requested (Choice 2)

DCC = Danville Community Center
OHP = Oak Hill Park Community Center
VMB = Veterans Memorial Building

Facility set-up instructions (be specific, e.g., include number of tables or chairs and their placement):

Resident fee (instructor receives 60% per student - Format: ##.##):

Additional materials fee, if applicable (must be able to justify with receipts):

If you are a potential, new instructor, have you completed and submitted a New Instructor Application?

Other notes for Coordinator:

Course Proposal