Community Ed Instructor Interest Form

1

Name* This field is required.

First Name

Last Name

2

E-mail* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

Are you filling this out on the behalf of a larger organization?* This field is required.

YESNO

5

What is the name of the organization?

6

Description of Proposed Course* This field is required.Please describe the course content and outcomes. Please list the name of the instructor if different from the person filing out this form. (Is this a course you've taught before? If so, feel free to skip this.)

7

Proposed Course Schedule* This field is required.Please suggest proposed length of the class (ex: "One Session, 2 hours, ideally on a Monday or Wednesday evening," or "Ten Consecutive Thursday Mornings from 9:30-11am."). In the following question, you'll be able to request a particular location.

8

Location/Modality* This field is required.Please tell us a bit about your preferences in terms of location/modality. Select all that apply.

Newport Campus

North County Center, Lincoln City

South County Center, Waldport

Zoom (Zoom-only or Hybrid)

Other

9

Where will the class take place?

10

About YouFirst-Time Instructors Only. Please tell us a bit about your experience or education related to this subject area, and why you believe you're the right person to teach this content to our community.

11

File Upload Feel free to share any files or links related to your course.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB