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Shared Learning Teacher Class Form

* indicates a required answer.

1. *

Teacher's Name:

2. *

Contact Info:

3. *

Class Name:

4. *

Class Fee:

5. *

Class Description (to be included on schedule):

6. *

Skills students will use in class:

7. *

Supplies students need to bring to class:

8. *

Max number of students:

9. *

Number of Assistants needed:

10.*

Age of Students:


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11.*

Which hour do you prefer?

 (1 required)
1st hr (9am) 2nd hr (10am)
3rd hr (11am)

Please note that we try to give everyone their preferred choice, but sometimes it doesn't work out that way.  Thank you for understanding!

12. 

Additional comments:

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