Instructor Name:
Contract Program: Yes No San Ramon Resident: Yes No
Proposed Program/Event Title:
Short Course Description (50 words max):
Detailed Course Description:
What is the intended OUTCOME of this program/event (other than revenue and number of participants)?
Must be simple, specific and measurable - how will we know the outcome has been met? (Ex. At end of session, participant will pass karate belt test and move to the next level)
How will the outcome be measured? (Pre and post test, survey/observation) Be specific and provide examples if possible.
Recreation Guide Description (100 word and benefit oriented description)
Competitive Research
Why are you proposing this program/event? (Be specific, i.e. trends, competition, need in the community, etc)
Who is your target market?
Is any other organization offering this in the Tri-Valley (Danville, Dublin, Pleasanton) Yes No
If yes, list source:
What is your competitive advantage?
Class Information
Class Date(s):
Class Time(s):
Course Fee: (Fee paid by participants. Instructor payment is 50% of the course fee.)
Additional Materials Fee (Collected by Instructor, If Applicable):
Minimum number of participants: Maximum number of participants:
Participant Ages: Instructor/Participant Ratio:
What facility and/or room are you proposing to use?
Could your program be drop-in? Yes No
Experience or pre-requisites needed before taking the class:
Recent Instructor Experience:
Date: Contact Person: Phone: Agency: Reason for Leaving:
Date: Contact Person: Phone: Agency: Reason for Leaving:
Date: Contact Person: Phone: Agency: Reason for Leaving:
Instructor Information
Business/Organization/Individual Name:
Address: City: Zip:
Day Time Phone: Cell Phone:
Email Address: Website:
Make checks payable to: Instructor Business
Upon approval of this proposal, instructors will be required to complete the following. Please initial beside each line below:
Complete fingerprinting & a TB Test
Provide insurance & worker’s compensation
Provide a completed W-9
Read instructor handbook
Instructor Acknowledgement:
I acknowledge that I have read, accept and understand the information and conditions that involve me or my company contracting as an Independent Contractor with the City of San Ramon. Submitting a proposal does not guarantee that the class or activity will automatically be added to the City of San Ramon’s public recreation offering. Additionally, once added no guarantees are made that the City of San Ramon will automatically continue offering the activity or program.
Signature: Date:
Security Measure