WaSLA Clock Hour Proposal Originator's Name *Local CouncilAddress *Email *Phone NumberProgram TitleStart DateStart TimeHoursMinutesAMPMEnd DateEnd TimeHoursMinutesAMPMTotal Instructional hours (excluding breaks & meals)Number of clock hours requestedTarget AudienceLocationNumber of ParticipantsTell us about the presenterPresenter/instructor(s)AddressDay PhoneCurrent PositionProgram Desciption0 / 200Presenter Qualifications/Vita Information0 / 200Who will be responsible for the clock hour forms?This includes distributing the forms to participants, collecting checks and completed forms at the conclusion of the workshop, and returning all materials:NameEmail Address Send Message
