Class Proposal Form
Fall 2013
Please Check One
____________ Down The Valley - Monday - Naugatuck
____________ In The Hills - Friday - Torrington
____________ In The Hills - Friday - Torrington
Name of Class or Activity __________________________________________________________________
Teacher:_____________________________________________________________________
Parent Facilitator: ____________________________________________________________
(Name, Email, Telephone)_______________________________________________________
Class Description: (please specity class content, activities, tc. _______________________________
__________________________________________________________________________
__________________________________________________________________________
Target Age Group: (as determined by the teacher and/or facilitating parent; please give a sense of whether you are firm or flexible about ages) _________________________________________
__________________________________________________________________________
Open to these ages:
□ 10-13
□ 13 & Up
□ Tweens & Teens
□ other specific age range (from ____ -to- ____ -years old) – Firm?
Min/Max Class Size: __________________________________________________________
□ specific minimum number of students allowed (____ students)
□ specific maximum number of students allowed (____ students)
□ flexible – no minimum or maximum limit
Time Needed:
□ one hour
□ one hour-and-a-half
□ other
specific amount of time (____ minutes)
Equipment Needs:
□ tables (number of tables - ____)
□ chairs (number of chairs - ____)
□ sink
□ chalkboard
□ other specific equipment needs:
Materials Needed: (please denote which materials will be provided by the teacher; estimate material fees)
___________________________________________________________________________
Tuition: $500.00 stipend per semester. This does not include any Material Fee. (For teachers from outside the cooperative).
No teaching fee may be charged (for teachers who are member of the co-op). Material Fee may be added.
Suited to: (skills or background needed for the class; types of interest…) _______________________
__________________________________________________________________________
Special Information: ___________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
On behalf of our Cooperative, thank you for your time and cooperation with this contribution!
Teacher:_____________________________________________________________________
Parent Facilitator: ____________________________________________________________
(Name, Email, Telephone)_______________________________________________________
Class Description: (please specity class content, activities, tc. _______________________________
__________________________________________________________________________
__________________________________________________________________________
Target Age Group: (as determined by the teacher and/or facilitating parent; please give a sense of whether you are firm or flexible about ages) _________________________________________
__________________________________________________________________________
Open to these ages:
□ 10-13
□ 13 & Up
□ Tweens & Teens
□ other specific age range (from ____ -to- ____ -years old) – Firm?
Min/Max Class Size: __________________________________________________________
□ specific minimum number of students allowed (____ students)
□ specific maximum number of students allowed (____ students)
□ flexible – no minimum or maximum limit
Time Needed:
□ one hour
□ one hour-and-a-half
□ other
specific amount of time (____ minutes)
Equipment Needs:
□ tables (number of tables - ____)
□ chairs (number of chairs - ____)
□ sink
□ chalkboard
□ other specific equipment needs:
Materials Needed: (please denote which materials will be provided by the teacher; estimate material fees)
___________________________________________________________________________
Tuition: $500.00 stipend per semester. This does not include any Material Fee. (For teachers from outside the cooperative).
No teaching fee may be charged (for teachers who are member of the co-op). Material Fee may be added.
Suited to: (skills or background needed for the class; types of interest…) _______________________
__________________________________________________________________________
Special Information: ___________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
On behalf of our Cooperative, thank you for your time and cooperation with this contribution!