PRCS Class Proposal

Please fill out and submit the following form regarding the proposed class you wish to instruct for the Novi Parks, Recreation, and Cultural Services department.

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

Email:

Please describe your experience/background in the proposed program. Include relevant certifications and years of experience:

Please provide a detailed Course Description:

List any previous experience or prerequisite of participants prior to taking class:

Please provide a four sentence description of your program that would appear in marketing materials:

If you selected 'other', please explain:

Proposed class duration (ex: 6 week session, 2 week summer camp, etc.):

Proposed class length (ex: 45 minutes, 1hr, etc.):

Please list the desired days to conduct the proposed class.

First Choice:

Second Choice:

Please list the desired times to conduct the proposed class.

First Choice:

Second Choice:

Will you be providing necessary supplies/materials for the class?:

YesNo

If yes, will you be charging a materials fee? What is the suggested price?:

If no, what supplies/materials do participants need to bring?:

Suggested per person activity fee:

Suggested Age Range:

Type of facility desired (classroom, dance studio, park setting, etc.):

Suggested Minimum Enrollment #:

Suggested Maximum Enrollment #:

What set-up would be required to run the proposed class (tables, chairs, whiteboard etc.):