Form to be filled in by viewer and emailed back to


Thank you for submitting a program proposal form for classes and workshops. Please be as concise and legible as possible. You will be contacted after we have reviewed this information if we are interested in offering this activity.


Program Information                                                   


Program Name:_____________________________ Submission Date:_______________________


Preferred Season (Choose the most appropriate option):

q  Winter, Jan-Mar (due beginning of September)

q  Spring, Apr – Jun (due beginning of January)

q  Summer, Jul – Aug (due end of March)

q  Fall, Sep – Dec (due beginning of June)

q  Any Season



Age Group(s): (Please check all that apply)


q  Infant/Preschool (0-5 yrs)         q Children (6-12yrs)      q Youth (13-18yrs)

q  Adults (19+yrs)                         q Older Adults (55+yrs)     Other ______________





q  Male

q  Female

q  Co-ed




Which of the following best describes the program you are proposing?

q  Art

q  Culinary

q  Educational

q  Fitness

q  Health and Wellness

q  Music

q  Sports

q  Special Event

q  Workshop

q  Other ___________________




Suggested Group Size: ___________________(i.e., Minimum 5 people – Maximum 15 people)



Suggested day(s) of the week you are available to instruct: (Please check all that apply):


q  Monday

q  Tuesday

q  Wednesday

q  Thursday

q  Friday

q  Saturday

q  Sunday




Suggested Time: (Please check all that apply):


q  Morning (9am-12pm)

q  Afternoon (12-5pm)

q  Evening(5-9:30pm)




Program Description: (Should be 50-75 words which can be used in our seasonal brochure)




Suggested Program Length: ________________________(i.e. 1/wk x 1 hr x 10 wks)          



Suggested Rate of Pay: $______/hr or %_______ of fee or $______ fee per student.



Employment Relationship:

q Contractor                                               q Employee

(Min. Req.: Current COV Business License)   (Min. Req.: Eligible to work in Canada)



Supply Costs: $______ per student  ______ None

(Detailed invoice for supplies will be required at time of billing)


Equipment Required: (mats, tables, chairs, etc.)__________________________________



Facility/Room Needs: (size, flooring, mirrors, etc.)________________________________







Full Name:                                                                    Phone: Home: (   )



Work 🙁   )                                Fax: (   )                                  Cell: (   )


Home Address:                                                             Postal Code:


E-mail:                                                  Website:



Qualifications/Experience: PLEASE ATTACH RESUME.



References: (Work, Personal, Educational)


Name:___________________________ Relation:____________________ Phone:______________


Name:___________________________ Relation:____________________ Phone:______________



Thank you for your submission!



Please fax or email this completed form with required attachments to: 604.718.6515 or with SUBJECT: PROGRAM PROPOSAL