Instructor Course Proposal Form

Question Title

* 1. Contact Information

First Name:

Last Name:

Primary Phone Number:

Contact Email:

Address 1:

Address 2:

City:

State:

Zip:

Question Title

* 2. Instructor Biography:

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 3. Resume, Certification, etc.:

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 4. References (if not listed on resume):

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 5. Are you a UCA employee?

Yes (FT)

Yes (PT)

Question Title

* 6. Social Connections:

Instructor Website:

Social Media Contacts:

Question Title

* 7. Course Content:

Course Title:

Class Times:

Course Dates:

Day(s) of the Week Taught:

Question Title

* 8. Course Description:

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 9. Upload Course Syllabus

The syllabus should include the course title, instructor content information, course objectives, course dates and times, course outline and content covered for each class.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 10. Marketing Audience Suggestions:

Question Title

* 11. Are there any co-instructors that will help teach this course?

Yes

If "Yes," Please list who:

Question Title

* 12. Course Set-Up Information:

Minimum # of Students:

Maximum # of Students:

Course Location:

A/V Request(s):

Question Title

* 13. Room Set-Up Style:

Classroom

Round Tables

Theatre

Board Room

Question Title

* 14. Course Registration Fee:

Question Title

* 15. Material Fee & Explanation:

Material Fee:

Material Fee Explanation:

Question Title

* 16. Upload Supply List (if applicable):

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File