OLLI@CCU Course Proposal Form

Fall 2016: Sept. 19 – Dec. 16

Email (preferred) completed form as a document to . Or mail completed forms to Course Proposal Form, OLLI/Office of Executive Development and Continuing Education, Coastal Carolina University, 900 79th Ave. N., Myrtle Beach, SC 29577, or drop it off at any of the outreach centers.

Fill in all blanks. Fill out a SEPARATE form for EACH class, club and location at which you would like to teach and return by March 15, 2016.

Instructor Contact Information
Your name as you would like to be listed in the catalog:
Mailing address:
Phone number: / Email:
Biography in 75 words or less (please refer to yourself in the third person):
Class/Club Information
Title of class/club:
Class/club description in 75 words or less:
Required materials (if needed, please include the amount of each material per student within the description):
If materials are to be supplied by instructor, indicate fee here:
Required text (if a text is required, please include title, author, publisher and ISBN):
Are you volunteering your teaching services for the course/club listed above? __ yes __ no
Schedule Preference
Location (select 1):
__ Conway __ Georgetown
__ Litchfield __ Myrtle Beach / Maximum number of students:
Day of the week Monday – Friday that you are able to teach:
Course length: __ 1 day __ 2 weeks __ 3 weeks __ 4 weeks __ 5 weeks __ 6 weeks __ 8 weeks
Dates course will not meet (dates you have commitments):
Please be respectful of staff, students and other instructors, and adhere to the schedule so the next class can begin on time. Please select times for your class/club from the options below. Highlight or circle your choice(s) of times.
1‐HOUR CLASSES / 9 -10 a.m.
9:30-10:30 a.m. / 10 -11 a.m.
10:30-11:30
a.m. / 11 a.m.-noon
11:30 a.m.- 12:30 p.m. / Noon-1 p.m.
12:30-1:30 p.m. / 1-2 p.m.
1:30-2:30 p.m. / 2 -3 p.m.
2:30-3:30 p.m. / 3 -4 p.m.
3:30-4:30 p.m.
90‐MINUTE
CLASSES / 9-10:30 a.m.
9:30-11 a.m. / 10-11:30 a.m.
10:30 a.m.- noon / 11 a.m.-12:30 p.m.
11:30 a.m.-1
p.m. / Noon-1:30 p.m.
12:30-2 p.m. / 1-2:30 p.m.
1:30-3 p.m. / 2-3:30 p.m.
2:30-4 p.m. / 3 -4:30 p.m.
2‐HOUR
CLASSES / 9 -11 a.m.
9:30-11:30 a.m. / 10 a.m.-noon
10:30 a.m.-12:30 p.m. / 11 a.m.-1 p.m.
11:30 a.m.-1:30 p.m. / Noon-2 p.m.
12:30-2:30 p.m. / 1-3 p.m.
1:30-3:30 p.m. / 2-4 p.m.
2:30-4:30 p.m.
3‐HOUR
CLASSES / 9 a.m.-noon
9:30 a.m.-12:30 p.m. / 10 a.m.-1 p.m.
10:30 a.m.-
1:30 p.m. / 11 a.m.-2 p.m.
11:30 a.m.-
2:30 p.m. / Noon-3 p.m.
12:30-3:30 p.m. / 1-4 p.m.
1:30-4:30 p.m.

The opportunity to teach evening courses will be available on a limited schedule. Please indicate below the time(s) you would like to hold class(es) in the evening.

Coastal Science Center ‐ Monday through Friday (classes must end at 8 p.m.)
Litchfield Education Center ‐ Tuesday (classes must end at 8 p.m.)
Myrtle Beach Education Center ‐ Thursday (classes must end at 8 p.m.)

Are you willing and able to present during A Taste of OLLI? _____ YES _____NO

Comments:

OLLI @ CCU Course Proposal 1

[Revised February 2016]