OSHER LIFELONG LEARNING INSTITUTE Volunteer Instructor E-Form PROPOSAL FORM – FALL 2016 OLLI Office Use Lead _____Bft __HHI _____Bluff ____ Jasp POTENTIAL & CURRENT OLLI INSTRUCTORS Complete this form using a word format. E-mail your completed form back to OLLI Director, Andréa Sisino at Sisino@uscb.edu. Winter/Spring proposals due by March 1. Name: Address: City: State: Zip: E-mail: Primary Contact Phone: Cell: Locations: (LIST ALL locations in the order of preference where you would like to present: Hilton Head Island Jasper Co. USCB Beaufort Campus – Beaufort USCB Bluffton Campus - Bluffton Potential Course: Please describe a course that you wish to offer for OLLI. Course Title: Description: Is this a brand NEW course for OLLI that you are proposing? Do you have a minimum number of students required? Maximum Number? Requirements: (i.e. books, AV, materials fees, etc.) ? Terms: Individual course sessions vary from 1.5 to 4 hours, and are generally scheduled Mon-Fri, from 9:00 am- 5:00 pm. Please indicate the day & time you prefer. FALL 2016 (9/ 26 – 12/ 9) Day(s) Preferred Beginning Date Preferred Time Preferred Number of Sessions Additional Questions: Have you taught this subject before? Yes ____ No________ If yes, indicate where and when: What are your credentials/experience which qualify you to teach this class? SHORT BIO Thank you! We value your contribution to OLLI! Rev. 12/15