Lifelong Learning Institute at Virginia Tech
  Lifelong Learning Institute at Virginia Tech

Lifelong Learning Institute at Virginia Tech

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Course Proposal Form

Please complete this form with the understanding that you may revise the course description and topics before the catalog is finalized.

1. Course Title:

2. Instructors/Coordinators:

Instructor 1

First Name
Last Name
Street Address
City
State
Zip Code
Phone
Email

Instructor 2

First Name
Last Name
Street Address
City
State
Zip Code
Phone
Email

3. Brief Background of Instructors (all or part of this will be used in the catalog, usually 1 or 2 sentences):
Instructor 1:

Instructor 2:

4. Course Description (suitable for advertising the course in the catalog; 1 or 2 paragraphs):

5. Specific Topics to be covered in the number of classes proposed:

6. Preferred Class Size:
15 or fewer Up to 25 Up to 32 Up to 50 50+

7. Preferred Session (include year): Fall Spring / Year

8. Preferred Number of Weeks/ Sessions (classes generally meet once a week):

Weeks:
6 weeks 5 weeks 4 weeks 3 weeks One time only
Other length:

9. Indicate preferred class time by selecting 1st choice in appropriate block; also select an acceptable 2nd choice.

Time Monday Tuesday Wednesday Thursday
9:00-10:30 1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
11:00-12:30 1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
1:00-2:30 1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
3:00-4:30 1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice
1st Choice
2nd Choice

Comments:

10. Recommended Textbook or Readings, if any (The required item(s) will be listed in the catalog so that participants can purchase them before class. You may also identify resources for participants on the first day of class.):

Title or website (NOTE: Do not include http in the website URL or the form will be rejected):
A. Required Recommended Handout

B. Required Recommended Handout

C. Required Recommended Handout

11. Materials participants will need to provide, if any

If participants will need to pay a materials fee for supplies the instructor provides or purchase their own supplies, please estimate the amounts, if you can. (We will verify the amounts before the catalog is published.) - Materials fee:$    Supplies fee:$

Comment or explanation:

12. Will copying of handouts be needed? Yes No
A maximum of 25 B/W pages or 10 color copies per student is a general guideline; additional copying may require an extra student fee. [Handouts can also be distributed to students electronically in pdf.] Estimates of the number of pages to be copied, both B/W and color, will be helpful. 

B/W copies per student
Color copies per student 

13. Room and equipment requirements:
Projector/Screen
Access to water
Internet access (for instructor only or also for participants):
  Instructor    Participants

Other special room arrangement or equipment requests:
Please describe. For example: lecture style set-up; seminar style (group around a center table); tables for working in small groups

14. Please list any potential guest presenters and their contact information:

15. Has this class been offered before through LLI: Yes No

If yes, when?

16. Course Category (choose one or two):

Art
Current issues
Film/Theater
Finance/Economics
Health/recreation
History
Literature
Living well/personal growth
Local culture
Music
Philosophy/Religion
Science, environment
Technology
Other (please name):


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