Program Proposal

Program Proposal

Thank you for your interest! In order to provide the best service possible to our patrons, we require all instructor-candidates to complete this proposal form. This form is for informational purposes only and does not imply a contract between the instructor and the City of Blue Ash. Your information will remain on file and will be reviewed periodically. In the event that there is a need for your program,you will be contacted to set up and interview with our staff.
Instructor Information
Name: *

First Name Last Name

Address: *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number: *

Area Code Phone Number
Email: *
Will strictly be used as a means of communication
Program Proposal
Name of Class/Program: *
Objective: *
Age of Participants to be Served: *
Best TIMES to be held: *
Best DAYS to be held: *
Duration: *
Please put a time frame and not just the amount of hours
Minimum Participants: *
Maximum Participants: *
Program equipment, materials, resources, etc. (jump ropes, balls, sound, etc.) you possess: *
Building equipment, resources, etc. (table, chairs, sound, electric, etc.) you would need supplied to you: *
Size of area needed for class (example: square feet): *
Describe what a participant would experience in a typical class (100 words or less): *
What fees would you charge the participants (i.e. $2 per class, $50 per month,etc.): *
Qualifications you possess: *
Do you have proof that this program and participants is protected by liabilityinsurance for at least $1M? *

Yes No No, but can obtain
References

Please provide two to three references that have been involved with your classes.These individuals can be current or previous participants, coordinators, etc.
Reference 1: Name *

First Name Last Name
Reference 1: Relationship *
Reference 1: Phone Number *

Area Code Phone Number
Reference 1: Secondary Phone Number

Area Code Phone Number
Reference 2: Name *

First Name Last Name
Reference 2: Relationship *
Reference 2: Phone Number *

Area Code Phone Number
Reference 2: Secondary Phone Number

Area Code Phone Number
If available, please provide any current media that we can reference (i.e. flyers, brochure, website, etc.) that will help us to better understand your proposal.

Thank you, again, for your interest in working with us. Please submit all materials and proposal to:

Program Manager

Blue Ash Recreation Department

4433 Cooper Road

Blue Ash, OH 45242

E-mail: programs@blueash.com

Fax: 513-745-8527
Should be Empty:

Program Proposal

Instructor Information

Program Proposal

References