THE OLDER ADULT LEARNING COMMUNITY
		PROGRAM PROPOSAL FORM - Winter 2027

If you are interested in being a leader or facilitator for a class or social event during Winter 2027, please fill out this form and email it back to info@theoalc.org. Or if you prefer, mail it to TOALC at 55 Smith St., E. Stroudsburg, PA 18301. I also accept PDFs or images (JPEGs or PNGs). But I can’t open Apple page files. ** Please respond by Friday, Nov 13, 2026. **

If you have any questions or need help filling out the form, please call Greg at: 570-422-7810 or e-mail: info@theoalc.org 

CONTACT INFORMATION - If you have led classes before, please update any information that has changed. I can identify you by the sender information in your email.

[ ] My contact information or bio has changed.(Y/N)

1. Name: 
2. Address: 
(If I have your address, I will mail you a copy of the final course book.)
3. Phone:
4. E-Mail Address:

5. Brief Bio (BETWEEN 20 - 40 WORDS PLEASE!!): 

COURSE INFORMATION

6. Course delivery method - check all that apply:  
   [ ]Email
   [ ]In-person indoor  
   [ ]In-person outdoor
   [ ]Video Conference
   [ ]Other - please specify: __________________________

7. Course Title:

8. Maximum Enrollment: 

9. Description of Program you would like to offer. A summary of main learning outcomes or objectives would be helpful. (BETWEEN 25 - 100 WORDS PLEASE!!): 

10. What is the level of risk for your proposed class, in your judgment?  [ ]Low [ ]Moderate [ ]Higher risk. 
Please describe risks of which participants should be aware.


11. Length of Course / Number of Weekly Sessions   Each session lasting 1-2 hrs:


12. Course dates and times, tentatively between Monday, Jan 25 - Friday, Mar 19, 2026 (8 weeks): 

[These can be any dates and times you choose but ideally during the usual TOALC class day.]

13. Instructional Equipment Needed: (TV, DVD/VCR Player, Overhead, etc.)

14. ***NEW QUESTION***: Estimated cost of materials to be paid by member (Books/Supplies).

Please email this complete form to: info@theoalc.org by Friday, Nov 13, 2026. Early submissions appreciated! If you must wait until a later date, please let me know when I can expect it. OTHERWISE, I WILL NOT ACCEPT YOUR PROPOSAL AFTER THE 13TH!