Chugach Optional 2011
Minicourse Instructor Sign-up Form
Name of instructor______________________________
Phone_____________ E-mail__________________
MINICOURSE NAME/TOPIC __________________________
(If you need help finding a topic, note so here)
MINICOURSE LOCATION: On-site Off-site: ____________
(A school chaperone will accompany all off-site courses) (note location here)
MINICOURSE DESCRIPTION: (use back of form as necessary) _____________________________________________________________________________________________________________________________________________
_______________________________________________
SPECIAL MATERIALS OR REQUIREMENTS, if any:
______________________________________________________________________________________________
_______________________________________________
Do you need help finding an assistant? Yes No
If not, note your assistant's name ________________________
If you want the Chugach community to cover any expenses, estimate costs here: _______________________________________
Minimum number of students in course _________
Maximum number of students in course _________
Ideal age group/grade levels _________
Ø Courses for primary kids (K-2nd grade) need to make room for snack breaks and recess at the usual times.
Ø If you have questions, concerns, night terrors, whatever, just contact Dawnell Smith at ChugachMinicourses@gmail.com or 243-5887.