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Class Proposal Form
1.
Contact Information
Name
Business Name (if applicable)
City
State
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIPy
Email Address
Phone Number
2.
Relevant Files: attach a resume or photos of your work
Choose File
No file chosen
3.
Class Topic (Suggested Title)
4.
Please provide a description for the class
5.
Preferred days and times to teach - check all that apply (Conservatory cannot guarantee availability)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning (start between 10-12)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Afternoon (start between 12-4)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Evening (start between 6-7)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6.
If proposed topic is a multi-week series, please indicate so along with number of sessions and frequency (if not, leave blank):
7.
Class Information
Max # Students
Min # Students
A/V or special set request needs
8.
Suggested price per person for registration:
9.
Supply and Material Information: List the materials and total cost.
Please note: Instructor is to bring own materials, listing materials and cost will assist the program coordinator with setting the price point.
10.
Agreement:
I agree that I am not currently an active volunteer of the Conservatory, and that my information may be kept on file for the future.
I agree