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Class Application 2016

* indicates a required answer.

1. *

Class Name (as you would like it to appear in the catalog)

2. *

Class Description (as you would like it to appear in the catalog):

3. *

Teacher Name (first and last please):

4. *

Teacher Email Address:

5. *

Teacher Home Phone Number:

6. *

Teacher Cell Phone Number:

7. *

Teacher Mailing Address (please include zip code):

8.

Co-Teacher Name (or None):

9.

Co-Teacher Email Address:

10.

Co-Teacher Home Phone:

11.

Co-Teacher Cell Phone:

12. 

Co-Teacher Mailing Address:

13. *

Minimum Number of Helpers Preferred:

14. *

Minimum Number of Helpers Necessary:

15.*

Ages (Select all that apply or select the minimum age required and Selected age and older):

 (1 required)
Nursery (Birth to 1) Toddler (Ages 1 & 2)
Preschool (Ages 3 & 4) Kindergarten (Age 5)
Age 6 Age 7
Age 8 Age 9
Age 10 Age 11
Age 12 Age 13
Age 14 Age 15
Age 16 Age 17
Age 18 Selected Age and Older
16. *

Minimum Number of Students:

17. *

Maximum Number of Students:

18. *

Absolute Maximum No. of Students - in case your class fills quickly and has a wait list, would you be willing to extend your maximum?  If so, please tell us the total number of students you can accommodate:

19.

Additional Helpers Needed if class fills to absolute maximum capacity

20. *

Materials Fee (how much will you need to spend per student for the entire semester?)

21.*

Weekly Homework:

 (1 required)
None < 1 hr/wk
1-2 hrs/wk 2-4 hrs/wk
4+ hrs/wk
22.

Prerequisite or Student Qualifications:

23.*

How many blocks will your class require?

 (1 required)
1 2
3
24.*

If your class length is only one block, would you consider offering it twice?

 (1 required)
Yes No
25. 

Additional Information or Special Requests:

26.*

I have read the Teacher Agreement and by submitting this application, I agree to adhere to the responsibilities within it and follow them.

 (1 required)
Submit
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