2. REQUEST FORM

School District (Name, Address & Contact Information) ______________________________

_____________________________________________________________________
Please provide the following information for each school you would like to include in the program:

School #1

· Name, Address & Contact Information ____________________________________________________________________

· Number of classes and grades (ex. 3 classes/ 3rd grade) ________________________________

· Total number of students _________________________________

· Amount of time available for Italian language course (per week) ______________________

· Start date requested (March  for 1 quarter OR August  for 1 school year)

____________________________________________________________________
 

School #2

· Name, Address & Contact Information _____________________________________________________________________

· Number of classes and grades (ex. 3 classes/ 3rd grade) _________________________

· Total number of students ______________________________________________

· Amount of time available for Italian language course per week ________________

· Start date requested (March  for 1 quarter OR August  for 1 school year)

__________________________________________________________________

Teachers

· Would this position require a full-time or part-time teacher? _______________

· Is there an Italian teacher already on-site? Yes _____ No _____

· If not, do you have a candidate for this position? Yes _____ No _____

          **If yes, please attach their resume to this form.**

Draft Budget Requirements

· Amount requested for TEACHER’S SALARY $___________________________


· Amount requested for INSTRUCTIONAL MATERIALS $ __________________