Instructor Intake Form, Cumming Arts Center

Instructor Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

This email will be your main contact for students and for notification of class registrations.

Phone *

Instructor Bio

Instruction/Demonstration Choices:

Course Name *

Course Description *

Charge for the Class *

Level (Beginner, Intermediate, Advanced, etc.) *

Class Location (For Example: Upstairs Classroom, Kitchen, Library)

Material List or please note if Materials are included.

Amount To Be Charged for Materials on day of class Please list forms of payment you will except from Students (i.e. Venmo, exact cash, check, etc.)

Instructor is personally responsible for taking material fee payments from each student.

List dates, start times, how many days for the class, how many hours per class., etc. *

Upload Image of yourself (portrait style)

Click or drag a file to this area to upload.

Upload Image of what you will create in class (or example of your artwork)

Click or drag a file to this area to upload.

Upload Image of what you will create in class (or example of your artwork)

Click or drag a file to this area to upload.

Upload Image of what you will create in class (or example of your artwork)

Click or drag a file to this area to upload.

Waiver

Agreement *

I have read & fully understand all the Instructor Guidelines and Requirements and agree to the above waiver.