Broadcast Instructor Request Form

Broadcast Instructor Request Form

**If the course is not already approved by TREC or you have not turned in the CE course application, please do that first before submitting this form.
Would you like to ADD a new course or DELETE an existing course on the Broadcast Schedule?*

AddDelete
Instructor Name*

First NameLast Name
Instructor Email*
example@example.com
Instructor Phone Number*
Please enter a valid phone number.
Broadcast Classes are scheduled Monday through Friday, 8:30a.m. – 5:00 p.m. Central, without overlap or repeat within a given week. Instructors are initially limited to 10 scheduled classes per quarter.
Requested Courses*
Course Title*
Course Number*
Zoom Link *
Number of Hours
Course Start Date

Please note: If courses are held once a week, a new form is required.
Start date*

MonthDayYear
Date
For a multiple day course, please provide end date

MonthDayYear
Date
Start Time*

Hour Minutes

AM/PM Option
End Time*

Hour Minutes

AM/PM Option
Please include alternate dates and times in case your first choice is not available
Start date*

MonthDayYear
Date
For a multiple day course, please provide end date*

MonthDayYear
Date
Start Time*

Hour Minutes

AM/PM Option
End Time*

Hour Minutes

AM/PM Option
Start date*

MonthDayYear
Date
For a multiple day course, please provide end date*

MonthDayYear
Date
Start Time*

Hour Minutes

AM/PM Option
End Time*

Hour Minutes

AM/PM Option
Should be Empty:

Course Start Date