Suggested Class Title ______________________________________________________________________
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Class Description __________________________________________________________________________
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Preferred Class Time (select one)
Monday 10 AM - 12 Noon ___ Tuesday 1 PM - 3 PM ___
Wednesday 10 AM - 12 Noon ___ Thursday 10 AM - 12 Noon ___
Location ______________________
Equipment Needed __________________
Zoom Proficiency Strong __ Moderate __ Weak __
Zoom coaching needed to sharpen skills Yes __ No __
Zoom tools desired Screen sharing __ White board __ Breakout groups __
Preferred Class Date(s) MM/DD/YYYY _______________
Speaker's Name ______________________________________
Speaker's Email ___________________________ Phone No. ________________
Speaker's Credentials (educational &/or experiential) ________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Class Submitted by _______________________________
Submit this form to David Gaynon at davidbruce3945@gmail.com
_________________________________________________________________________________________
Class Description __________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Preferred Class Time (select one)
Monday 10 AM - 12 Noon ___ Tuesday 1 PM - 3 PM ___
Wednesday 10 AM - 12 Noon ___ Thursday 10 AM - 12 Noon ___
Location ______________________
Equipment Needed __________________
Zoom Proficiency Strong __ Moderate __ Weak __
Zoom coaching needed to sharpen skills Yes __ No __
Zoom tools desired Screen sharing __ White board __ Breakout groups __
Preferred Class Date(s) MM/DD/YYYY _______________
Speaker's Name ______________________________________
Speaker's Email ___________________________ Phone No. ________________
Speaker's Credentials (educational &/or experiential) ________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Class Submitted by _______________________________
Submit this form to David Gaynon at davidbruce3945@gmail.com