Instructor Proposal Form

      This form may be completed online or downloaded and mailed upon completion. Click here to download.

      Proposals must be received by December 1, 2011.


    Instructor Information (Note: Person who will actually be teaching the course)
    Name (last, first, m.i.) , , ,
    Conference Badge Name
    Agency / Company
    Title / Rank
    Agency Address
    City / State / Zip Code , ,
    Agency Phone
    Agency E-Mail
    Home Address
    City / State / Zip Code , ,
    Home Phone
    Home E-Mail
    Personal Cell/Pager
    Business Cell/Pager
    Preferred Contact Home Agency
    Shirt Size M L XL XXL XXXL
    I do NOT authorize SOTA to provide my preferred contact e-mail address to SOTA conference vendors.
    Course Information
    Course Title
    Course Type Lecture Demonstration Hands On Instructor Certification / Armorer
    Attendee Requirements Duty Rig Training Gun Training Knife Protective Gear Training Baton Other:
    Instructional Track Instructor Certification / Armorer Officer Safety / Use of Force Specialized
    Instructor Development Combatives Tactics Firearms Training / Deadly Force
    Live Fire Firearms Training Management & Administration of Training
    Course Prerequisites
    Certification & Armorer Courses Only Course Registration Point of Contact:
    E-Mail Address:
    Length of Course 2 hours (x2) 4 hours (x1) 8 hours (x1) Other:
    Maximum Number of Students
    Special Fees / Costs
    Only for certification/armorer courses and only to cover costs of attendee materials. This fee is not mandatory. Maximum $35, collected by instructor.     		$
    Please describe such materials below if a fee is required.
    Facility Requirements - Please bring your own laptop computer. Check all that apply, below.
    Classroom Theater seating will be standard Mats (required for D/T) Adjust Lighting Other:
    AV Needs Projector DVD Flip Chart Other:
    Indicate which day(s) you will NOT be able to present - (Availability will influence course selection).
    Sunday (March 4) Monday (March 5) Tuesday (March 6)
    Secondary Instructor
    Name (last, first, m.i.) , , ,
    Conference Badge Name
    Agency / Company
    Title / Rank
    Agency Address
    City / State / ZIP Code , ,
    Agency Phone
    Agency E-Mail
    Home Address
    City / State / Zip Code , ,
    Home Phone
    Home E-Mail
    Personal Cell/Pager
    Business Cell/Pager
    Preferred Contact Home Agency
    Shirt Size M L XL XXL XXXL
    I do NOT authorize SOTA to provide my preferred contact e-mail address to SOTA conference vendors.
    Please describe any other special needs for your course in the space provided below:
    (Resources are limited. We will attempt to honor your request, if possible.)
    Course Description: To be printed as written below (limited to 525 characters including spaces)
    Please provide a single paragraph synopsis of the course, including learning outcomes/competencies, in the space below. Please use complete sentences with no bullet points, numbers, or unnecessary spacing. (Note also course outline requirement below).
    Instructor Bio: To be printed as written below (limited to 450 characters including spaces)
    Provide a brief bio, including instructional experience, written in the third person in the space below. Please use complete sentences in a single paragraph with no bullet points, numbers, or unnecessary spacing.
    Additional Information - Do not include any other attachments or documents.
    Please include any information that might be helpful to the course selection committee in the space provided below.
    Digital Handout Materials
    In the space below, please describe materials - in addition to the course outline - that you will provide for inclusion in the digital handout provided to attendees to help attendees utilize what they learn from this course.
    Brief Course Outline
    Please submit a course outline. Please include relevant instructional goals/objectives, course content/topics, instructional methods, materials and any attendee assignments/evaluation. This outline will aid in course proposal selection and be included in attendee digital handouts.