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EISD Enrichment Course Proposal for Summer 2012

Please fill out and submit one form per class, per campus.

Classes Term is Monday, June 4 to Friday, August 3, 2012
*Classes will not meet July 2 - 6.

Contact: Jerri Ann Yznaga - Community Enrichment Coordinator
Phone: 512-732-9022 x1

Community Enrichment classes provide the community with opportunities to learn, explore and improve in their area of interest. The Enrichment classes are offered at all nine district campuses, after school and in the evening.

Thank you very much for your interest in teaching an Enrichment class through the Eanes ISD Community Education Program. This course proposal will ask a series of questions to assist us in determining if your proposed course meets the interests and needs of the students and community. Please provide a concise description of the course for the course catalog.

Please indicate in the proposal your tuition charge for the course. A percentage of the course fee will go back to Eanes ISD. Community Ed reserves the right to suggest a change in fee based on what is considered reasonable and fair. You may also elect to charge a materials fee, covering any supplies needed for the class. 100% of these fees will be refunded to the instructor with proper receipts and documentation.

Instructor/Company Information

* Contact and/or Company Name

* Day Phone

* Mobile Phone

* Email Address

* Address (city,state,zip)

* Please Select:

EISD Staff

Non-EISD Staff

* Is this your first time teaching with the EISD Community Education Program?

Yes

No

Class Information

* Class Title

* Class Description

* Class Fee

Material Fee (If applicable)

* Max. Number of Students

* Is your course a morning, afternoon or all day class?

Morning

Afternoon

Evening

All-Day

* What hours will your class run? example: 9:00am - 10:00am

* Category

* Target Grade Level(s)

* Preferred Day(s) your class will meet each week. *DO NOT mark more than one day, or we will assume that your class will be meeting multiple times during the week.

* Preferred Start Date. (On or after June 4th.)

* Preferred End Date. There are no classes July 2nd - 6th.

* Total number of sessions in your course from beginning to end.

* Class Duration

* Type of Space Needed (If you are an EISD teacher and will be using your own classroom please indicate your classroom number in the "Other" field)

Education Background

* What special experience or education qualifies you to teach this course?

* Present Place of Employment

* Title

Statement of ADA and Section 504 Compliance

*

Eanes ISD prohibits unlawful discrimination against individuals with disabilities. No qualified individual with a disability shall, by reason of such disability, be excluded from participation in or denied the benefits of the services, programs or activities of the District or of its contractors. A qualified individual with a disability is a person who, with or without reasonable accommodations, meets the essential eligibility requirements for the receipt of services or the participation in programs or activities provided by the District or its contractors.

You may wish to consult Eanes ISD Board Policies GA (Legal), GKD (Legal), and GKD (Local). You may also wish to consult your own legal counsel regarding your obligations to comply with the law, including ADA.

I have reviewed and agree with the Statement of ADA and Section 504 Compliance. Please intial in the box below, that you have read the above. If you need a paper copy please call the Community Education office.

Notes

* Indicates Response Required

Classroom	Art Room
Large, Open Space	Gym
Field	Stage
Other