Course Proposal Form

Deadlines:

Fall catalog (late Sept-mid Dec): June 1st

Winter catalog (late Jan-March): October 1st

Spring catalog (late April-June): February 1st

Web Site

First Name: *

Last Name: *

Address: *

Address, Line 2:

City: *

State: *

Zip Code: *

Email Address: *

Daytime Phone: *

Evening Phone (if different):

May we provide students with your telephone number(s) and/or email should they have questions? *

Yes No

Which Number(s)/Email? Check all that apply.

Day Evening Email

If you have a website, please enter the URL here. Otherwise, leave blank.

Course Name: *

In which category does your class belong? *

Arts & Crafts Computers Cooking & Foods Dance Family & Home Health & Exercise Kids & Teens Mind & Body Money, Money Sports & Recreation Talks & Walks Working for a Living Words & Music

Write a specific 50-100 word course description. Refer to the class capsules in the catalog for examples. *

Put yourself in the student's shoes. What will students get out of the course? Why should they take this class? *

Provide a biographic statement about yourself, your experience and why you are qualified to teach this class. *

Days Available to Teach: *

Mon Tue Wed Thu Fri Sat Sun

Times Available: *

Morning Afternoon Evening

If you have specific date(s) or time(s) in mind, please list them here.

How long would each class be? One hour, two? Longer? *

How many weeks would it take to teach the course? *

Suggested course fee:

Materials fee?

What is the maximum number of students you can have in the class? (MALT has a minimum of 4-5 students for the class to run) *

Do you have any special classroom needs? (Internet, LCD projector, etc.)

You may also submit a photo of yourself (a headshot or teaching) for us to use online and in our print catalog. Photos should be at least 900px x 900px to be used in print.

Photo for possible inclusion in the catalog

6601 Greene St, Philadelphia, PA 19119
215-843-6333, Hours: Mon-Fri, 9 AM-2 PM