INSTRUCTOR FORM

COMMUNITY CHURCH COLLEGE

1501 LA JOLLA AVE, SUN CITY CENTER, FL 33573-5329

SEMESTER ____________ YEAR ________

INSTRUCTOR: ___________________________________________________________________________________

ADDRESS: ______________________________________________________________________________________

PHONE: _______________ FAX: _______________ EMAIL ____________________________________

COURSE TITLE: __________________________________________________________________________________

COURSE DESCRIPTION: __________________________________________________________________________

________________________________________________________________________________________________

DAY REQUESTED: ___ MON ___ TUE ___ WED ___ THU

TIME: 8:30 - 10:00 AM_____ 10:30 - Noon_____ 1:00 - 2:30 PM_____ 3:00 - 4:30 PM_____

Walk-Ins: Yes___ or No___

EQUIPMENT NEEDED: LECTERN___ MICROPHONE___ CHALKBOARD___ COMPUTER PROJECTOR___

OVERHEAD PROJECTOR___ TV___ VCR___ Other________________________________

ROOM SET-UP: Tables and Chairs___ Chairs Only - Rows___ Circle___ Against the wall___

Other set-up instructions: ___________________________________________________________________________

BRIEF BIOGRAPHY: _____________________________________________________________________________

________________________________________________________________________________________________

PLEASE BE SURE THAT THIS INFORMATION IS PRESENTED AS YOU WISH IT TO APPEAR IN THE CATALOG.

BE AS BRIEF AS POSSIBLE. RETURN COMPLETED FORM AS SOON AS POSSIBLE. THANK YOU.

DR. YVONNE PONSOR, DEAN. PHONE 634-8607, FAX 633-9033.
NOTE: THIS IS AN APPLICATION, NOT A CONTRACT Rev. 03/06/2008