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"The man who graduates today and stops learning tomorrow is uneducated the day after." - Newton Diehl

Instructor Commitment Form

Spring Term Deadline is 2/1/10

Instructor Information

Name:
Address:
City:
State:
Zip:
Phone:
Email:
Instructor(s) Biography:
(80 words or less pertaining to the presentation/class)

Course Information for Winter Term 2010

  1. Title of Course:
  2. Course Description (80 words or less):
  3. Anticipated cost of books/materials to be incurred by students:  $
    4. Note: Due to copyright laws, copying of published material by the OLLI office is limited.
  4. How many total class sessions do you plan?  
  5. Preferred day(s) of week for class meetings (please indicate 1st, 2nd and 3rd choice):
    • First Choice:    From:   

    • Second Choice:    From:   

    • Third Choice:    From:   
  6. Is there a reason to limit enrollment? If so, please indicate a number:
  7. What instructional or A/V equipment will you need:
    LCD Projector
    Laptop
    DVD Player
    VCR Player
    CD Player
    Record Player
    Flip Chart
    		 Overhead Projector
    Podium
    Slide Projector
    Tape Player
    Television
    Chalk Board
    Other (please specify):
  8. Do you need a technology assistant to help you operate the A/V equipment during class?
    Yes No

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

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

OLLI at WVU, Center on Aging | Robert C. Byrd Health Sciences Center
Mountaineer Mall, Unit D-9 | 5000 Greenbag Road | PO Box 9123 | Morgantown, WV 26506-9123
Phone: 304-293-1793 | Fax: 304-293-4779 | Contact the Webmaster
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