City of Brentwood
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Home Parks and Recreation Get Involved Program/Activity Proposal Form
Program/Activity Proposal Form
Please complete entire form
Instructors Name:
Business/Organizaation:
Address:
City:
Zip Code:
Day Phone:
Evening Phone:
Checks made payable to: Instructor Business
Email Address:
Web Site Address:
Brochure Editions: Fall/Winter
      Oct 1-Jan 31
Winter/Spring
      Feb 1-May 31
Summer
      June 1-Sept 30
Course Title:
Detail Course Description:
Course Objectivies:
Learning Outcomes: (what will the participant learn/what are the benefits of taking the class.)
 
Please give us a five sentence description of your program that will appear in the City's Activities Guide (Be creative):
 
Participant's Ages:
Class Session Length: If other, please state:
Class will be held:
Once A Week Twice A Week Other
Which Day of the Week:
Monday Tuesday Wednesday Thursday Friday
Class Times:   to am pm
Number of Sessions: (List all sessions and dates below in the comment area of this form)
 
Course Fee:
Number of Students Needed: Minimum Maximum
Type of Facility Needed:
Lab Fee or Supplies Fee:
This fee should NOT be included into the class fee.
Is there any additional cost to the participants? Yes No
If Yes, describe in detail:
*Please e-mail your resume that pertains to your class or programs to dept-parkrec@brentwoodca.gov or mail it to 150 City Park Way, Brentwood CA 94513 Att: Poldina Scherff, Recreation Supervisor.
Please compile below a list of names, addresses and telephone numbers of at least three references.

Name:
Address:
Phone:

 
Name:
Address:
Phone:

 
Name:
Address:
Phone:

 
Comments: (Please add any additional sessions, with dates, times and "no class" dates)
 

 
Submit Completed Proposal
 
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"Creating Joyful Community Experiences through People, Parks, and Programs"
 
Parks & Recreation Department       (925) 516-5444
35 Oak Street       (925) 516-5445
Brentwood, CA 94513       dept-parkrec@brentwoodca.gov
Operating Hours 8:00 a.m - 5:00 p.m.
After Hours Emergency Phone 382-5346