1. Course Title _______________________________________________________ 

2. Name ____________________________________________________________ 

Building __________________________________________________________ 

Position __________________________________________________________ 

Home Telephone Number _________________________ 

E-Mail Address _________________________________ 

3. Course Outcomes (Identify what participants will know and be able to do.) Please be aware that courses should increase the technology knowledge base and skills of staff rather than focus on curriculum, instruction, or materials development. There are other district and building funds available for the development of projects. 

__________________________________________________________________________ 

__________________________________________________________________________ 

__________________________________________________________________________ 

__________________________________________________________________________ 

4. Provide a brief description of the software application/technology and its use. 

__________________________________________________________________________ 

__________________________________________________________________________ 

__________________________________________________________________________ 

__________________________________________________________________________ 

__________________________________________________________________________ 

6. Class Size Minimum _____________ Maximum _____________________ 

7. Course Logistics Proposed Number of Hours for the Course _________________ 

(2-12 hours is a recommended range.) 

Proposed Dates _________________________________________________________ 

Proposed Days of the Week _______________________________________________ 

Preferred Time(s) - Check all that apply. 

_____ Weekdays 3:30 - 5:30 _____ Weekdays 4:00 - 6:00 

_____ Weekdays 6:00 - 8:00 _____ Saturdays 8:00 a.m. - Noon 

_____ Saturdays 1:00 p.m. - 5:00 p.m. _____ Other 

Proposed Meeting Location ________________________________________________ 

8. Participant Prerequisites (Knowledge & skills required prior to enrollment.) 

__________________________________________________________________________ 

__________________________________________________________________________ 

9. Does the software and hardware required to conduct this workshop currently exist at the location proposed above ? Yes No 

Comments: _________________________________________________________________ 

___________________________________________________________________________ 

Please be prepared to provide a description of the topics and activities for each 

session of the proposed course if the course is approved. Please call Rosalie or Shelia at 346-4745 if you have any questions regarding the course proposal.