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Osher Lifelong Learning Institute

Special Interest Group (SIG) Proposal Form

Please complete this form to propose or renew a SIG

OLLI at USM Special Interest Group proposal

OLLI at USM Special Interest Group proposal

SIG Coordinator First Name *

SIG Coordinator Last Name *

Email *

Phone *

Address *

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Date of Birth *

Is there a co-coordinator? *

Yes

No

First Name of co-coordinator

Last Name of co-coordinator

Email of co-coordinator

Phone of co-coordinator

Address of co-coordinator

Address of co-coordinator

Address of co-coordinator

Address of co-coordinator

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Date of Birth of co-coordinator:

Catalog Details

Course format (Check all that apply):

Lecture

Discussion

Film

Hands on

Movement

SIG Name *

SIG Description for use in the catalog (50 words max) *

If nothing is different than before, just say ‘same as before’.

SIG size details.

Do you have MAXIMUM number of students for your SIG? *

Yes

No

What is the max number of participants? *

Preferred Meeting Dates and Times

Program/Membership Year *

How/where do you plan to meeting? *

In-Person in Wishcamper

In-Person but off site (walking/ski/bike clubs)

Remotely via Zoom

Preferred Day In Wishcamper – First Choice *

Preferred Day In Wishcamper – Second Choice *

Preferred Day & Time Slot In Wishcamper – Third Choice

How frequently does your SIG meeting? *

Weekly

Once a month

OtherOther

If your SIG meeting once a month, what week of the month does it meet? * If your SIG meeting once a month, what week of the month does it meet?

Room Request in Wishcamper?

If you have a request, let me know. Just be aware the room may not be available.

Anything else?

If you are human, leave this field blank.

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