SVETN ITV Class Proposal

Directions: Provide the following information on this form and click the 'Submit' button at the bottom of the page.

Contact Information

1. Your First Name:  Your Last Name:   2. Name of most recent school employer     Address:   City:  State:  Zip Code:   3. Your Email Address:   4. Your Telephone Number:

Course Proposal

1. Title of Proposed Course:   2. Prerequisite(s) for course:     3. Target grade level(s):     4. Will a textbook be required for this course? Yes No     If yes, provide bibliographical information and ISBN (if available) for the book(s) you are considering. (It is not necessary that this detail be firmly established at this point, but we would like to have an idea about planned resource materials.)   5. Provide a description of the course.     6. Why do you feel this course is needed in Southwest Virginia?     7. What professional and personal experiences attracted you to this opportunity?     8. Do you have the appropriate credentials to teach AP or dual enrollment?     9. Would you be willing to teach on a block schedule?