Broward UP Partner Information Session, Course, and Workshop Request Form

Broward UP Partner

Information Session, Course, and Workshop Request Form

Please let us know if your organization would like to offer Broward UP Information Sessions, Workshops, and/or Courses, and in what delivery modality. We will try our best to accommodate specific requests based on programming type and instructor availability.

Parner Name*

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Organization Name*

Location Street Address

City*

Zip Code*

Requester's First Name*

Requester's Last Name*

Email*

Phone Number

Phone

Service Request*

Which Service Are Your Requesting?

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Information Session Date*

Please allow at least four weeks of lead time for any information session request.

Target Audience*

Select all that apply.

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Preferred Information Session Format*

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Additional Details Needed*

Please provide additional details on the nature of your request.

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What Is The Event?*

Provide a brief description of the event.

Workshops*

Select all the apply.

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Workshop Format*

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Location Address*

Street, City, Zip Code

Room Access: Select All That Apply*

Does the room/location have AV (Audio/Visual) access for a presentation, computers, and the internet?

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Number of Attendees*

What is the estimated amount of participants/attendees?

Course Modality and Availability*

Online-LIVE – This option allows students to gather at partners' locations to watch live lectures of the course broadcast online. Partners will need to collaborate with Broward College to determine if partner location(s) are equipped with the technology to broadcast live lectures.

Face-to-Face – This option allows student to gather in-person at partner locations with a live instruction. These requests are based on instructors' availability and student enrollment. A minimum of 12 enrolled students are required to facilitate an on-site course. Some courses are available face-to-face only at specific location. For example, Health Care courses are presently only available at Broward College @ YMCA and Sunshine Health in the Lauderhill Mall, and the CDL program is currently facilitated only at the FLA Live Arena in Sunrise, Fl.

Hybrid - This option allows students to take part of their course the in-person, face-to-face format, and part in the Online-Live format. This blended format is currently only available at Broward College @ YMCA location. However, please let us know if this is of interest to you for future semesters.

Fully Online - This option allows students to take their coursework completely online in the asynchronous format. There is no minimum enrollment required to offer this format.

Please allow 8 to 12 weeks of lead time to facilitate a course.

Select or enter value

Adult Education @ The YMCA in Lauderhill

Mondality - Hybrid

By choosing this option, you request to collaborate with Broward College to share this course option with your residents/constituents.

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Community Courses @ Sushine Health in Lauderhill Mall

Modality - Face to Face

By choosing this option, you request to collaborate with Broward College to share this course option with your residents/constituents.

Select

Community Education Courses @ The YMCA in Lauderhill

Modality - - Face to Face, Online-Live, Online

By choosing this option, you request to collaborate with Broward College to share this course option with your residents/constituents.

Select

Commercial Driving License - CDL

Mondality - Face to Face at the FLA Live Arena

By choosing this option, you request to collaborate with Broward College to share this course option with your residents/constituents.

Select or enter value

Online Self-Pace

Modality - Online

By choosing this option, you request to collaborate with Broward College to make this course option available to your residents/constituents.

Select

Courses Available To Facilitate At Partners Location

By choosing this option, you request to collaborate with Broward College to make this course option available to your residents/constituents.

Requests for in-person course delivery are based on availability and participation. A minimum of 12 residents is required to facilitate an on-site course.

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