Osher Lifelong Learning Institute – OLLI Course Proposal Form

Thank you for your interest in teaching at OLLI Mason. Please fill out the following course proposal form in its entirety, as we need all of this information for curriculum development. Click guidelines on writing OLLI course descriptions.

Forms will be reviewed by OLLI’s Program Planning Committee with the aim of providing a diverse and quality curriculum of interest to our membership. Expect a prompt response about your proposal from our program planners.

Term

Class Number (Ex. F102)

Course Title*

Course Description (recommend no more than 150 words - can be revised at a later date)*

Please enter the number of class sessions needed.*

Preferred Location: Please select all that apply.*

Loudoun
Reston
Fairfax
Any

Would you be willing to repeat this course in the future at another OLLI location?*

No
Loudoun
Reston
Fairfax
Any

Select Choice of Time and Day:

Choice 1:*

Choice 2:*

Choice 3:*

Any scheduling conflicts?

Max. Number of Students: (insert "no" or maximum #)*

Min. Number of Students: (insert "no" or minimum#)*

Unique Classroom Need?

All OLLI classrooms are equipped with state of the art audiovisual equipment to support all types of academic presentations. A site assistant will contact you at a later date regarding specific set-up needs. If you know now that you will need something extraordinary in the classroom that may impact your room assignment - like a piano, kitchen - please indicate that below.

Instructor 1 Information:

Name:*

First Last

Email:*

Daytime Phone:*

Alternate Phone:*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Instructor Bio (Limit: 50 words.)*

Instructor 2 Information (if applicable):

Name:

First Last

Email:

Daytime Phone:

Alternate Phone:

Instructor 2 Phone (alternate):

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Other

Are you already working with an OLLI member or staff on this course proposal? If so, indicate here:

Email

This field is for validation purposes and should be left unchanged.