EmailMe Form - GP&R Program Proposal (Short Form)

Date submitted

MM / DD / YYYY

Name *

First Last

Business Name (if applicable)

Address *

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

Email *

Primary Phone *

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

Alternate Phone

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

Proposed Program Title

Used for print and on-line listings. It is best to choose a name that immediately gives prospective participants a good idea of what the program involves.

Age Group

Children

Teens

Adults

Ages of Particpants

Employee or Independent Contractor?
Check all that apply

I have formed a business for this type of work (listed above).

I provide similar programs at other agencies.

I can provide a certificate of insurance.

GP&R hires both employees and independent contractors to lead programs. Based on the number of boxes checked, the Town of Groton will make a final determination of how you will be hired

Program Description

(This text is used to create write-up for our catalog and on-line listings. Be short and concise and use active verbs).

Be specific and complete.

Explain how underserved members of the community will benefit from this program.

Describe what steps you will take to welcome diverse participation and make it easier for people who wouldn't normally participate to join in.

Day(s) of the week

Times (start - end)

Number of weeks

Min/Max class size

Minimum and maximum class sizes should be based on providing the best user experience possible, what you feel comfortable teaching, and what is appropriate for the size classroom.

Season

Fall (by May)

Winter (by September)

Spring (by December)

Summer (by March)

Check all that apply. Typically, new programs are offered for the first time during the Spring season. The months listed after each season reflect deadlines for having proposals accepted.

Supplies and Equipment

List any supplies or equipment that you will provide and whether any fees are charged to participants. Any supplies needed for a class must be pre‐approved by the Program Supervisor. This should be considered when determining class fees. If a supply fee is required for each student, it must be approved and published in the program guide.

Supplies and Equipment (that partcipants must provide)

List any supplies or equipment that participants must provide. Do not include fees that participants must pay from the previous form field.

Requested rate of pay per hour

$ Dollars

Instructors maybe paid per hour. Usually, GP&R retains a portion of revenue collected for each class and pays the remaining amount to the contract instructor. The final payment terms as negotiated with GP&R are listed on the contract or offer letter. Rates of pay are negotiated based on a number of factors including facility space required, new vs. continuing program, number of participants expected, number of programs provided, and other details.

Provide details about other similar programs that exist in the area.

Instructor Qualifications

List any certifications, training, experience, skills, etc. related to your proposed class.

By clicking "submit" below, you agree that the information contained in this proposal is accurate and correct to the best of your knowlege and you consent to GP&R contacting the references listed.