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Exit Survey
2019 Discovery Proposal Form
This is the class proposal form for the 2019 Discovery program at VCU's Mary and Frances Youth Center. Discovery focuses on provided STEAM-H career exploration classes for rising 6th-8th graders, and class offerings can be full day, or half day for one week. For questions, email us at
[email protected]
or visit our website at,
mfyc.vcu.edu
. Please complete and submit your proposal(s) by February 6, 2019.
Class Instructor Information
*
Class Name
*
Instructor Name
*
Instructor Email
*
Instructor Cell Phone Number
*
Instructor Office Phone Number (If Applicable)
Instructor Address:
*
What is your affiliation with VCU?
9 Month Faculty
12 Month Faculty
Staff
Student
Alumni
Not affiliated with VCU
*
What is your highest level of education?
High School
Associates Degree
Undergraduate Degree
Graduate Degree
Doctoral Degree
*
If you are connected to VCU, please list which department you are with or your major. If you are not affiliated with VCU, please list your current position and employer.
*
I am willing to provide this class at no cost to Discovery. Review the
benefits of volunteering
with Discovery.
Yes
No
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