Yes, I am willing to host a class in the Winter 2018 term!

Thank you for your willingness to serve as a Host for the Winter 2018 term.  Providing the information requested below will help match your wishes to our needs.  Please provide the complete name of the course.

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* 1. First Name

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* 2. Last Name

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* 3. Phone Number

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* 4. Email Address

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* 5. Course Name (1st choice)

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* 6. Start Date of Course

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* 7. Course Name (2nd choice)

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* 8. Start Date of Course

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* 9. Additional comments concerning hosting a course

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