OLLI UHM Instructor Questionnaire Step 1 of 5 20% Instructor InformationFull Name First Last Email: Instructor StatusNew OLLI-UHM instructorReturning OLLI-UHM instructorAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary PhoneAlternative Phone Course DetailsTerm (Fall/Spring/Summer) and YearCourse Subject AreaPick the most applicable heading. If your course straddles two or more areas, choose “Multidisciplinary/Other”Art & Art HistoryFilm, Music, & TheaterHistory & CultureLanguagesLiterature, Poetry, & DramaMultidisciplinary/OtherPhilosophy, Religion, & PsychologyPolicy, Politics, & Current EventsPractical Arts, Games, & HobbiesScience & TechnologySocial SciencesWellness, Health, Fitness, & ExerciseWritingCourse Title (subject to revision):What is the official title of your course? We encourage you to create one that is explanatory, creative, and inviting.Course Description (subject to revision)Provide a brief course description outlining major topics and course format (e.g., lecture, discussion, participatory or interactive). This description is the primary marketing tool for your course. Use action verbs, and list specific topics and areas of special interests in order to better inform members what will be covered and why they should be interested. If appropriate, provide a list of suggested reading material, noting whether any reading is to be done prior to the start of the classes.Instructor Bio (subject to revision)Provide a brief biographical sketch. Tell us how you know your topic and how it interests you (include your current title, if applicable). Course SchedulingPreferred Start Date:Please pick at least two possible start dates for your course.Class length (hours):11.523Select day and time (1 hour class) Monday, 12:30 to 1:30 pm Monday, 4 to 5 pm Tuesday, 4 to 5 pm Tuesday, 6 to 7 pm Wednesday, 9:30 to 10:30 am Thursday, 3:30 to 4:30 pm Friday, 3 to 4 pm Select day and time (1.5 hour class) Monday, 2 to 3:30 pm Tuesday, 11:30 am to 1 pm Wednesday, 7 to 8:30 pm Thursday, 9 to 10:30 am Thursday, 11 am to 12:30 pm Friday, 9 to 10:30 am Friday, 11 am to 12:30 pm Friday, 1 to 2:30 pm Select day and time (2 hour class) Tuesday, 9 to 11 am Tuesday, 1:30 to 3:30 pm Wednesday, 11 am to 1 pm Wednesday, 2 to 4 pm Thursday, 1 to 3 pm Select day and time (3 hour class) Monday, 9 to noon Number of Sessions:12468Other (specify)Other (specify): Additional Course DetailsPreferred Maximum Enrollment (#)Fees and Materials:Are there any materials (e.g., art supplies, textbooks) students are required to purchase themselves before classes begin? Please consult with the director in determining appropriate materials fees expectations and arrangements.Skill or Physical Ability Requirements:Help students select your class by outlining your expectations of them. Should they have prior knowledge or some particular level of skill? What physical health or strength is required? Are there accessibility or mobility parameters? Questions or Comments:CommentsThis field is for validation purposes and should be left unchanged.