OLLI Study Group Worksheet: Summer 2017

Please Confirm Dates/Times at Earliest Convenience
Final Worksheet Description Due Friday, March 3, 2017

Name of Study Group
Facilitator
(if more than one facilitator, please complete additional information on reverse side)
Facilitator title/background

Email address
Postal address

Phone (home) ______(work) ______(cell)

Have you facilitated an OLLI Study Group before? □ Yes □ No

Is this a new or repeat OLLI Study Group? □ New □ Repeat


Study Group description (please include any required book purchases or pre-study group assignments):
(please limit to 100 words; attach separate sheet if necessary)

Summer 2017 begins June 1 and ends August 31.
Please choose from the following days/times:

Day:

□ Monday / □ Tuesday / □ Wednesday / □ Thursday / □ Friday

Time:

□ 8:15 – 10:30 a.m. / □ 9:00 – 11:15 a.m. / □ 9:30 – 11:45 a.m. / □ 10:00 a.m. – 12:15 p.m.
□ 1:00 – 3:15 p.m. / □ 1:15 – 3:30 p.m. / □ 1:30 – 3:45 p.m. / □ 2:00 – 4:15 p.m.


Minimum Group Size: ______

Dates: ______to ______Number of Sessions: _____ Maximum Group Size: ______

Date and Time Flexibility: □ My dates and times are flexible □ I must have these dates and times
Would you like a Study Group Host? □ Yes □ No
If yes, do you have a preferred host? ______
Study Group Category:
□ Discussion-based: participants will be asked to read material and participate in whole group discussions
□ Participation-based: participants will be asked to read material, participate in small group breakout discussions, and may make brief reports

□ Practice-based: participants will be asked to learn a skill set and engage in practice between sessions

Preferred Location (first and second choice):

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□ Heartis Village

□ Hult Center for Healthy Living □ Humana Guidance Center

□ Lutheran Hillside Village

□ Michel Student Center

□ Peoria NEXT Innovation Center

□ Peoria Public Library

□ Proctor Place

□ United Presbyterian Church

□ Universalist Unitarian Church

□ UnityPoint-Methodist North

□ NO PREFERRED LOCATION

P:\coe\OLLI\2017 Summer\17SU Study Groups\17SU Study Group Worksheet.docx

Course technology:

Please consider your needs carefully, as we are unable to fulfill any last-minute requests.

P:\coe\OLLI\2017 Summer\17SU Study Groups\17SU Study Group Worksheet.docx

□ I will supply my own laptop
□ Laptop computer w/ DVD

□ Speakers for computer

□ Whiteboard / chalkboard
□ Projector & screen
□ Clicker for PowerPoint slides

□ VCR and monitor
□ Podium with microphone

□ Lapel microphone
□ Laser pointer
□ Piano

□ CD player

□ Other ______

P:\coe\OLLI\2017 Summer\17SU Study Groups\17SU Study Group Worksheet.docx

Additional Study Group Facilitators:
(Attach separate sheet if necessary)

Name ______Phone (h) ______

Email ______Phone (c) ______

Address ______

P:\coe\OLLI\2017 Summer\17SU Study Groups\17SU Study Group Worksheet.docx