Program Proposal Form

Welcome! Cobscook Institute is a community center in eastern Maine – a community resource intended to be accessed and enjoyed by our local community and beyond! We invite folks to submit proposals/ideas for workshops, skill shares, events, clubs, and gatherings that align with Cobscook’s mission and values, and support a thriving, connected, and engaged community. Thank you for reaching out to share your idea for a course, event, or program!

Please note that Cobscook Institute staff need at least 8 weeks lead time to advertise and promote events/programs. Additionally, if you are proposing a program for which you seek/need compensation, our current rate for course instructors is $30/hour.

Name*

First NameLast Name

Pronouns*

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

What's the best way to communicate with you?*

EmailTextPhone CallOther

Please describe the program you'd like to offer.*

What are the recommended ages for your event?*

What is the maximum number of participants you can accommodate?*

Do you have a preference on when you'd like to offer this program (note: staff need 8 weeks lead time)? Please share specifics on if this is a one time event or if you imagine this as a multi-session program. What month(s) would you like to offer this? How many sessions? What time of day?*

Tell us a little about yourself. What background/experience do you bring as an instructor/facilitator to this program? Feel free to upload supporting materials (resume, CV, images of your work, images of teaching that help us understand who you are as an instructor/facilitator).*

Please input any promotional websites we can use for you (website, social media, online articles etc):

ONLINE W9 FORM

I have completed the above W9 Form:*

Yes

What is your discussed rate of pay for the event?*

Is there any basic equipment that participants should bring?

Is there any specialized equipment that you will provide?

Do you need materials for your event? If you are providing the materials, what is the fee per student?*

What are the recommended ages for your event?*

What is the maximum number of participants you can accommodate?*

Contract Details

Cobscook Staff will confirm your course date, time and compensation via email.

The event is contingent upon minimum enrollment of 6 participants. If we must cancel due to low enrollment, we will let you know as soon as possible.

You must complete all duties for the duration of your one-time event or your entire series.

If an emergency prevents you from this at any point, please contact Cobscook Staff (207-733-2233).

You must complete a online W9 Form which will be provided.

Compensation will be recived via mail to the address in this agreement within 30 days of completeing your event.

You will convene classes to be inclusive to all, regardless of religion, sex, gender, sexual orientation, marital status, national origin, citizenship, service in the military or veteran status, ancestry, age, physical or mental disability, medical condition, or any other status protected by law.

You will convene classes with compassion & awareness.

Liability

I recognize there are risks involved in participating in Cobscook Institute courses and activities, and accidents or injuries may occur. I therefore assume all risks associated with or arising from my participation in Cobscook Institute activities and hereby release, disclaim and exonerate the Cobscook Institute , its staff, volunteers, and board of directors, from any and all injuries, losses, damages, or other adverse consequences arising during, directly or indirectly, from my participation in Cobscook Institute activities.

Media Release

I grant my consent to Cobscook Institute to use my/my child’s likeness, whether in still or motion pictures, my/my child’s photographs and/or reproduction, including voice and features, with or without my child’s name. I agree that I am not entitled to compensation of any kind arising from the use of my/my child’s likeness.

I agree to the terms of this contract as indicated above.

Signature*

Thank you for your proposal!

A staff member will contact you.