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Community Member Program Proposal Form
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This form has been modified since it was saved. Please review all fields before submitting.
First and Last Name
Proposed Program Information
Detailed Program Description
This will be used for online and print promotion.
Time of Year
Fall / Sep - Dec
Winter / Jan -Mar
Spring / Apr - Jun
Summer / Jul -Aug
Frequency of Event - How Many Days Per Week?
Check all that apply
Describe Target Audience
Minimum # of Participants
Maximum # of Participants
Recommended Instructor Compensation Per Participant ($)
Describe requested compensation
Waive Instructor Fee?
Does instructor/organization have insurance?
If yes, please upload a copy
Ideal Type of Space
(e.g. open area, classroom, etc.)
Are there supplies/equipment the participant will need to bring?
If yes, what supplies/equipment will be needed?
For use in our print/digital promotion
Upload Bio or Photos
.pdf, .doc, or .jpg
Instructor Qualifications (trainings, education, work experience, certifications, etc.)
Thank you for your interest in offering a program with the Community Services Department. Your proposal will be reviewed to determine if it meets the needs of our community – after which you will be contacted where details can be discussed. Call or email the Department of Recreation and Parks with questions regarding this form: 802 777 1621 / email@example.com Please note: The City of Winooski attempts to offer programs at the lowest possible price as a service to our community. Instructor compensation is one of the factors considered when determining program offerings. We welcome those who wish to donate their time as a service to our community.
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