Program Proposal Form

Please complete the form below. after your form has been submitted, One of our staff members will contact you to ask for your current resume and two references.

Applicant Information
Applicant Name *
Applicant Name
Street Address *
Street Address
Preferred Phone *
Preferred Phone
Program Information
Session(s) *
Please select any or all that apply.
Available Days *
Please select which days you would be available to instruct the class.
An estimate is acceptable.
Enter the amount of time needed to set-up for each class.
What equipment will you be bringing to the class?
Class/Program Description
Is this program adaptable to persons with disabilities? *
Please enter your proposed financial compensation per class. If this is a volunteer program, please enter "0"
I hereby confirm that all of the information provided is correct and completed to the best of my ability and understand that I will be contacted in request of a current resume and two valid references.