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"The person who graduates today and stops learning tomorrow is uneducated the day after.”

Instructor Commitment Form

Lead Instructor

Name:
Address:
Phone:
Email:
Area of Expertise/Position/Degree:
Biography:

Course/Workshop Information

  1. Semester and Year Offered:  
  2. Suggested Title of Course or Workshop:
  3. Course or Workshop Description:
  4. Course or Workshop Objectives:
  5. Texts/Handouts/Reference Materials?
  6. How many total class session do you plan?
  7. Preferred day(s) of week for class meetings? Please list 1st, 2nd, and 3rd choices.
    • First Choice:    From:   
    • Second Choice:    From:   
    • Third Choice:    From:   
  8. What course "prerequisites" (or interests or participation guidelines) would you suggest for individuals taking this class?
  9. What enrollment limit would you prefer (classrooms seat 55)?
  10. What instructional or A/V equipment will you need?
    LCD Projector
    DVD Player
    Flip Chart
    Microphone
    Overhead
    Podium
    Slide Projector
    Sound System
    Tape Recorder
    Television
    VCR Player
    Other (Please Specify):
  11. Do you plan to collaborate or team-teach with another instructor? Please provide names(s).
  12. What other special considerations do you suggest? (i.e., moveable chairs, tables, etc.)

If you have any questions about this form, please call Nancy Merrifield at the OLLI office: 304-293-1793.

Office hours are Monday through Friday from 9:00 am until 5:00 pm.

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