New Course Proposal Form
Fill out the required fields below. Some questions may ask for alternative answers in case there are any scheduling issues. If you have any questions, contact Dani Castillo-Dávalos at daniela.castillo-davalos@oregonstate.edu .
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Email *
Full Legal Name *
Preferred/Chosen  Name *
Phone Number
What is your course title? (Limit 10 words) *
What is your course description? (Limit 75 words) *
Remember to address your description to your target audience's anticipated vocabulary and interests
What is your targeted grade level? (Check all that apply) *
Required
What day of the week would you like to meet? *
Choose your preferred dates, actual date will depend on the course schedule
Required
What hours would you like to meet? *
Time
:
If the hour that you requested doesn't work, what would be another hour you could meet?
Time
:
What date would you like to start? (Check the course start week calendar at https://beav.es/47A) *
MM
/
DD
/
YYYY
What is the maximum number of students you are willing to take in you class? (Suggested: Up to 8) *
What materials/equipment do you anticipate students will need for your class? *
Provide a brief course outline by week. (4 weeks) *
Select the option that is true about you *
To ensure that individuals who join 4-H & U are well qualified and have a strong potential to be productive and successful employees, it is 4-H & U’s policy to investigate the backgrounds and employment references of applicants. In addition, 4-H & U may conduct background investigations when volunteers are being considered for entrance or in furtherance of an internal investigation of alleged misconduct. Background investigations will be conducted at 4-H & U’s discretion and in accordance with federal and state law. Print your name below if you are in accordance with 4-H' & U's background check policy. *
A copy of your responses will be emailed to the address you provided.
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