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First Name *

Instructor Last Name *

Address *

City, State and Zip Code *

Home Phone

Cell Phone *

Email Address *

Suggested Course Title *

Suggested Course Description *

How many weeks do you think your course will last? *

What are your room needs? (When we are able to teach classes in person) *

How many hours will your class be taught each session?

What is your preferred day to teach? *

What are your equipment needs? *

What will your students need to bring to class? *

If supplies are needed, will students purchase these from you the first night of class or on their own?

If textbooks, will students purchase these from you the first night of class or on their own?

Please describe text book and/or supplies and approximate cost?

Would you be able to teach this course online? Yes or No?

If yes, do you know how to use Zoom, or is there another platform you prefer? We will be offering lessons on how to use Zoom; will you need training from us?:

If you would use Zoom, do you need the school to provide you with a Pro account or do you already have one? *

Have you taught this class elsewhere? *

If yes, who may we contact?

If no, please provide a reference.

What is your suggested bio for the catalog?

Questions or Comments

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