EmailMe Form - 2017 Instructor Proposal Form

Any instructor wishing to be considered to teach at the Annual Training Conference MUST submit a proposal with a LESSON PLAN no later than October 30, 2016* to be considered. *date subject to change

Lesson plans and other documents can be uploaded using the file upload at the end of the form. No submission will be reviewed unless an adequate lesson plan has been submitted. The ATC Instructor Selection Committee will review all proposals and notify all individuals selected thereafter. If additional space is required, please submit additional page/s.

Thank you, we sincerely appreciate your efforts on IALEFI®’s behalf.

IALEFI, 25 Country Club Rd., Ste 707, Gilford NH 03249 - Phone 603.524.8787, Fax 603.524.8856

Instructor Proposal Form: Some of this information will appear in the 2017 ATC Brochure, (if your proposal is selected), therefore, please provide the information as you would like to have it represented.

Primary Instructor *

First Last

Agency

Is this your home addresss?

Yes

Mailing Information

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email *

Confirm

Instructor Biography: Limit to 75 words (You may send your entire resume', however, you must submit a condensed resume' of 75 words or less to be used, IALEFI® will not rewrite your resume'.

Course Information

Course Title

Course Objectives

Overall Course Summary

Please note: Four hour courses are taught twice (AM & PM same day), eight hour blocks are taught twice (consecutive days), and 16 hour courses are taught once. However, should you have an sixteen hour class and would like to teach it twice, we can most likely accommodate you. (check only one)

Number of Students: (maximum)

Note: With the exception of the armorer courses, the class minimum number of students is set at 20 unless safety considerations mandate otherwise.

Audio Visual Requirements
IALEFI is unable to provide laptop computers for any classroom or range presentations.

Please make sure to indicate everything that will be needed for your program. Wireless microphones will NOT be available in standard classes of 24 people or less.

Checkbox

Slide Projector w/Screen

LCD w/Screen (limited availability see acknowledgement below)

Flip Chart / Dry Erase Board

Other - Be SPECIFIC

OTHER Equipment needed, if more space is needed complete at the end of the form

Acknowledgement:
I have read and understand the limitation of equipment usage and the posssibility of NOT having an LCD available. If this box is not checked, it will be assumed you have not read this statement and your proposal will be returned.

I have read the Acknowledgement

Student Requirements
Please make sure to indicate everything that will be needed for your program

Please be realistic in your ammunition requirements. In the past few years students are shipping a lot of ammunition they never fire. If your course requires 500 rounds then make sure you utilize that number of rounds, not 150. Carefully review your drills to determine EXACTLY what the ammunition requirements will be. These large ammunition request are particularly hard on our International members who must obtain ammunition when they get here and cannot carry it back with them.

No Additional Equipment Needed

None

Equipment Required

	Ammunition Required
Physical Training Attire
Hand Gun
Shotgun
Rifle
SMG
Duty Belt

Additional Student Requirements (Be Specific with your needs)

Would you be willing to share your course information with all participants at the IALEFI® conference in the form of it being copied onto cd's or mini-drives?

(Checking No will NOT have any impact on the selection committee's decision)

Yes I would

No, I prefer not to

Co-Instructor

Co-Instructor: IALEFI will provide individuals to assist as safety officers if you need help, however, should you feel it is paramount that another instructor assist you in the presentation of your course, please provide the following information for that instructor, and fill in his/her name in the block below.

INSTRUCTORS PLEASE TAKE NOTICE: IALEFI will waive the ATC Registration Fee ($495) for the primary instructor if you choose to attend the entire ATC, however, the co-instructor will receive a participant packet, complementary banquet meal, and the ATC registration fee will be reduced to $250.00.

If classes are to be taken a formal registration form with class selections must be completed by both the primary and co-instructor.

File Upload

	4 Hours	8 Hours	16 Hours
Range
Classroom
Armorer

Course Information

Audio Visual Requirements ***IALEFI is unable to provide laptop computers for any classroom or range presentations.***

Student Requirements Please make sure to indicate everything that will be needed for your program

Co-Instructor

Audio Visual Requirements
IALEFI is unable to provide laptop computers for any classroom or range presentations.

Student Requirements
Please make sure to indicate everything that will be needed for your program