CANTERBURY ELDERCOLLEGE Course Proposal Form (We would be delighted to work with you in developing your proposed course) Course Title:__________________________________________________________________ Title should be catchy/explanatory and maybe with a bit of zing! Instructor’s Name:____________________________________________________________ Course Description: Briefly explain what the course will cover (between 75 and 125 words) Length of Course (in hours): _______ All courses should be at least 2 hours or longer. You can choose to offer your course all in one day or divide it up in several sessions over several days. (Courses less than 2 hours need approval by a Curriculum Committee Chair) # of Sessions (optional): If you are doing more than 1 session each individual session should be at least 2 hours. (Sessions less than 2 hours need approval by a Curriculum Committee Chair) Please describe the individual sessions in 1 or 2 sentences. Session 1: Session 2 Session 3: Session 4: Session 5: Session 6: Class Size: Minimum ______ Maximum ______ Minimum: Three (3) is the preferred ElderCollege minimum. Requests for a higher minimum # of people attending will need to be approved by a Curriculum Committee Chair. Maximum: Determined by 1 or more of the following: A. The type of course. Some hands on courses (eg. cooking) may need to be small B. Maximum number the instructor is comfortable teaching C. Maximum size of room being used Instructor(s) Bio Notes: (40-60 words) Instructor Availability: Please check ALL days, times and locations that work. You will be contacted to finalize the details. Days of the Week: Mon. ___ Tues. ___ Wed. ___ Thurs. ___ Fri. ___ Weekend days can be offered under some circumstances: Sat. ___ Sun. ___ Time of Day: Morning ___ Afternoon ___ Location: Amherstburg ___ Chatham ___ Essex ___ Kingsville ___ Lakeshore ___ LaSalle ___ Leamington ___ Tecumseh ___ Windsor ___ Other: _______________ Material Fees*: If your course requires participants to use materials that will cost money to purchase (costs that are above and beyond the Course Fee) such as: books, additional copying, food/drink that are a part of the instructing, entry fees (museums, event tickets, etc.). Please tell us about the type of items you will be purchasing and the cost per person. This way we can reimburse you for the expenses with receipts of purchase. $_______/per person - Type of Items: ____________________________________ *TRIPS: If a bus is required for your course please contact the Administrative Office to make the arrangements. (519) 253-3000 X 4901 or fettesc@uwindsor.ca Instructor Contact Information: Phone #: __________________________ Email: ____________________________________ Address:______________________________________________________________________ (OPTIONAL) …………………………………………………………………………..…………………………… Course Manager: All courses are assigned a Course Manager to help with the basics of facilitating the course, such as: introductions, Sign In Lists, refreshments and Participation Feedback Forms. Please choose from the following options: I will be my own Course Manager _______ Please assign a Course Manager _______ I would like _________________________to be my Course Manager. (name)