Course Proposal Form
Dover/Lewes/Ocean View/Bridgeville
Instructor Information
Instructor Name *
Your answer
Instructor Address *
Street
Your answer
Instructor Address *
City
Your answer
Instructor Address *
State
Your answer
Instructor Address *
Zip
Your answer
Home Phone
Including area code XXX-XXX-XXXX
Your answer
Cell Phone
Including area code XXX-XXX-XXXX
Your answer
Email Address
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone
Including area code XXX-XXX-XXXX
Your answer
Emergency Contact Relationship
Your answer
Do you want your name, address, phone number and email address published in the Osher directory? *
Are you? *
Instructor Biographical Information *
Limit to 40 Words or Use Existing Biographical Information
Your answer
Course Information
Guidelines for Writing Course Descriptions:
* Be Brief: Limit description to 50 words or less to convey course content.
* Be Concise: Answer the “who, what, where, when, why & how” in the first sentence or two.
* Convey Instruction Methods: What portion of the instruction will generally be lecture, film, activity,
discussion, or other?
* Convey Expectations: What are prerequisites, previous courses, background, materials to be purchased,
copy expense, limitations (activity level), degree of difficulty (if applicable) etc.?
* Brief Subjective Comment: (Optional) What a student might expect, find useful, find entertaining, etc.
Course Title *
Limit to 30 characters including spaces
Your answer
Course Description
Limit to 50 Words or Use Existing Course Description
Your answer
Category *
Has this course been offered before?
Would you like to plan a class trip?
Would you like to plan a class trip?
If yes, please describe (limit to 200 characters)
Your answer
What year would you like to teach? *
Your answer
What semester would you like to teach? *
Length of Course *
Location of Course *
Day Preference - Dover *
MUST ENTER ONE ANSWER FOR EACH DAY
Preferred
Doable
Not an option
Monday
Tuesday
Wednesday
Thursday
Day Preference - Lewes *
MUST ENTER ONE ANSWER FOR EACH DAY
Preferred
Doable
Not an option
Monday
Tuesday
Wednesday
Thursday
Day Preference - Ocean View *
MUST ENTER ONE ANSWER FOR EACH DAY
Preferred
Doable
Not an option
Monday
Wednesday
Day Preference - Bridgeville *
MUST ENTER ONE ANSWER FOR EACH DAY
Preferred
Doable
Not an option
Wednesday
Day Preference Comment
Your answer
Time Preference - Dover *
MUST ENTER ONE ANSWER FOR EACH TIME SLOT
Preferred
Doable
Not an option
9-10:15 a.m.
10:30-11:45 a.m.
1:00-2:15 p.m.
2:30-3:45 p.m.
Time Preference - Lewes, Ocean View, and Bridgeville *
MUST ENTER ONE ANSWER FOR EACH TIME SLOT
Preferred
Doable
Not an option
9-10:30 a.m.
10:45 a.m.-12:15 p.m.
1:30-3:00 p.m.
3:15-4:45 p.m.
Time Preference Comment
Use this section if you would like a time period different from the options above (example: 1:00-4:00)
Your answer
Equipment/Materials to be supplied by Osher
Will you be using internet videos for your course?
Estimated number of handouts (individual pages) per student
Anything over 10 copies per student will be charged to the student at a rate of $.08 per page
Your answer
Additional fees, books or supplies
Please include Title and ISBN for required readings.
Your answer
Prerequisites
Your answer
If you need to limit class size, what is the maximum number of students?
Your answer
I understand and agree that the University of Delaware, its Trustees, employees and agents have no legal responsibility for my physical welfare while I am volunteering at the Osher Lifelong Learning Institute at the University of Delaware or a participant of any program -sponsored trip. I, therefore, agree to hold the University of Delaware, its Trustees, employees and agents harmless for any claims for personal injury or damage arising out of my association with the program. I also authorize the University of Delaware to record and photograph my image and/or voice, for use by the University or assignees in educational and promotional programs and material. *
Thank you for volunteering to teach! You will receive confirmation once your proposal is submitted. If you do not receive confirmation your proposal has not been submitted.
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