NEW COURSE PROPOSAL – please complete entire form
Name of presenter:
Address:
Telephone: (cell)
(home)
(work)
E-mail address:
Website:
You can provide students my: [ ]Email address
[ ] Phone number
[ ] I am not a retired STRS employee
[ ] I am willing to be hired as an employee (not a contractor)
SS # or Tax I.D. #:
Occupation:
Salary Expectation (please see the cover letter for examples):
Note: We are required to have a copy of your general resume on file. Please submit it with this application.
SPRING 2014 DATES: Community Service Classes will begin February 1 and end May 31, 2014.
MiraCosta SPRING 2014 Holidays (do not schedule classes on these dates):
2/14-2/17 (unless class is held offsite); 3/14-3/16 (unless class is held offsite); 5/24-5/26.
Please submit form(s) by Monday, September 16, 2013.
Name of class:
Preferred location: [ ]Oceanside [ ]San Elijo [ ] Other ________________________________________
Classroom requirements: [ ]Standard classroom (comes with instructor computer, overhead projector)
[ ]Tables (not tablet armchairs) [ ]Sink [ ]Computer lab
[ ]Other ____________________________________________________________
Proposed date(s) of class (no class on Sundays and the following dates: 2/14-2/17 (unless class is held
offsite); 3/14-3/16 (unless class is held offsite); 5/24-5/26):
Proposed times of class:
Amount of time for setup: [ ]15 min [ ]30 min [ ]45 min [ ]1 hour [ ]Other __________
Amount of time for clean up: [ ]none [ ]15 min [ ]30 min [ ]Other ____________________
Minimum number of students:
Maximum number of students:
I am willing to work with students under 18: [ ]Yes [ ]No
If “Yes,” the youngest age I am willing to work with is:
Does the child need to be accompanied by a parent/guardian? [ ]Yes [ ]No 

Proposed fee to student:
Materials fees (paid by students directly to instructor – please note what material fees cover):
Materials (What materials must the student have and bring to class? Attach separate list if necessary):
NOTE: We are required to have a reference copy of the curriculum and materials for each of our Community Services
classes. If your course is approved, you will be required to provide our office with a copy of all curriculum and materials
you will be providing to the students.
Outline of information to be covered (Course content):
Class/Seminar objectives (What do you want the student to learn?):
Demand (Why do you think there is a need in the community for this type of class?):
Competition (Have you seen this type of course offered at other places? Where and by whom?):
Experience (Have you taught this subject before? Where? What were the results?):
Promotional paragraph suitable for publication:
Provide 2 References (either a supervisor or someone who has taken a class from you):
1. Name:
Relationship:
Email:
Phone:
2. Name:
Relationship:
Email:
Phone:
MINIMUM REQUIREMENTS
Community Services Class. A Community Services class is a class which meets the following minimum
requirements:
1. Is designed for the physical, mental, moral, economic, career or civic development of persons enrolled therein.
2. Provides subject matter content, resource materials, and teaching methods which MiraCosta College deems
appropriate for the enrolled students.
3. Is open to all members of the community.
4. Is not intended for the promotion of the instructor and/or his/her business interests.
5. Must potentially attract enough participants that the tuition charged will cover all costs associated with offering
the class.