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:	Chose One 1 Day 2 Days 4 Weeks 5 Weeks 6 Weeks 8 Weeks Other 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:	am pm   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 oruiz@ci.brentwood.ca.us or mail it to 730 Third Street, Brentwood CA 94513 Att: Olivia Alvarez, 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