Full Name

Mailing Address

City                               State            Zip Code
        

Telephone Number

Course Time Preference (check all that apply. Course times are approximate)

8:15am-10:00am 
10:15am-12:00pm
12:45pm-2:30pm
2:45pm-4:40pm
Half-Day Workshops - Mornings
Half-Day Workshops - Afternoons

Months Available.
June
July
August (first two weeks)
All Sessions/Flexible (Note: This does not mean you will need to teach in all sessions)

Please give a brief course description for the class you would be interested in teaching. If you are interested in teaching more than one course, you must fill out a new form for each class. Thank you! 


What materials and resources would be necessary to teach this course and what is the estimated cost of materials per child? For example: If you were proposing teaching an art course, list all of the materials needed for your purposed project(s) and the cost per child for these materials. If you need a speciality location (ie, dance studio, outdoor field, etc) for your course, also please specify here.