I. Course Title

II. Course Description

III. Course Information

Total number of course hours
Hours per session
Sessions per week
Total number of weeks

Preferred:
  Dates
  Days
  Times

Preferred class location:
   Baytown - Main Campus
   San Jacinto Mall
   Crosby Center
   Other

Textbook required: Yes No
   If Yes:
      Title
      Author
      ISBN#
      Publisher

Media equipment needed: (check all that apply)
   Computer w/ LCD projector
   Other

Supplies needed:
   For Lee College to supply
   For student to supply
   Estimated cost for supplies $

IV. Targeted Population

Kids: (check all that apply)
   Elementary
   Junior High
   Senior High School

Adults: (check all that apply)
   Adults
   Senior Citizens

Other specific characteristics

V. Instructor Information

Name
Address
City, State, Zip
Home Phone
Day Phone
E-mail Address

The standard instructor fee is $20 per hour. Is this fee acceptable to you?
Yes No
If no, what would be an acceptable fee? $ per .

VI. Course Objectives

If you have questions or want to set up an appointment to discuss the course proposal, call Kimberlee Whittingtonat 281-425-6457. You can mail to PO Box 818, Baytown, TX, 77522-0818, Fax 281-425-6855, or bring to C.E. Office in Rundell Hall on the main campus in Baytown.