Recreation Program Proposal

City of Greenville Parks, Recreation & Tourism

Community Center Program Proposal

Thank you for your interest in becoming a program instructor with the City of Greenville Parks, Recreation & Tourism. In order to be considered as a program instructor, you must complete and submit this program proposal form describing the class, activity or program that you would like to offer/instruct. All classes, activities or programs must be done at one of our Community Centers. Please note that not all proposals are accepted, or accepted at the time they are submitted.

Contact Information

Name*

First Name

Last Name

Company/Organization Name (if applicable)

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Primary Phone Number*

Email*

Website

Program Overview

Program Name*

Type of Program*

Art/Dance Athletics Education and Enrichment Environmental Fitness and Health Leisure and Social

Other:

Intended Audience (check all that apply)*

Preschool (Ages 3-5) Youth (Ages 5-11) Pre-Teen (Ages 11-13) Teen (Ages 13-18) Adult (Ages 18 & Up) Seniors (Ages 55 & Up) All Ages

Other:

Gender*

Male Female Any

Preferred Location (check all that apply)

Bobby Pearse Community Center David Hellams Community Center Juanita Butler Community Center Nicholtown Community Center West Greenville Community Center

Description of Program*

Please write a description of the program you would like to offer and include details such as skills/techniques being taught, any curriculum information, staff ratios, tools, supplies, etc.

Goals of Program*

Please include how the residents of the City of Greenville will benefit from this program.

Program Details

Program Start Date:*

Program End Date:*

Program Start Time:*

Program End Time:*

Number of Weeks*

Day(s) of the Week*

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Minimum Number of Participants*

Maximum Number of Participants*

Proposed Program Fee*

Individuals wishing to provide instruction or service for compensation are required to obtain an agreement/contract prior to providing instruction.

Is Financial Aid offered if inquired?*

Yes No

Equipment and Supplies

What equipment and/or supplies will be provided by the instructor?*

What equipment and/or supplies will the City of Greenville Parks, Recreation & Tourism need to provide for this program (including tables, chairs, audio-visual equipment, screens, hoops, etc)?*

What will the participants be required to bring?*

List any special site or set-up requirements that would need to be addressed prior to the program.*

Instructor Qualifications

List experience and qualifications to instruct this program.*

Are you certified in First Aid, CPR or AED? (Check all that apply)*

First Aid CPR AED None

Other than the City's marketing initiatives, how do you plan to advertise? Do you currently have any participants or prospects?*

Disclaimer and Signature

All approved programs will require the instructor to undergo a background check, facilitated by the City of Greenville.

The instructor will not be considered regular employee of the City of Greenville Parks, Recreation & Tourism and will not be entitled to any benefits afforded to regular wage employees including (but not limited to) insurance, sick leave, vacation leave, workers compensation or any other employee benefits given to regular wage employees of the City of Greenville Parks, Recreation & Tourism and I accept this responsibility.

Registration will be handled by the City of Greenville Parks, Recreation & Tourism Department and all fees will be paid to the department by participants. Submission of this form does not guarantee approval of the course, location or dates/times. There is no exclusivity to instructors or the programs they teach. If providing instruction or service for compensation, an agreement/contract is required prior to providing instruction or service. The City of Greenville Parks, Recreation & Tourism will issue payment to instructors after receipt of services and submission of valid invoice.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Today's Date

Signature

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