Rourke Art Education Course Intake Form
Part 1. Contact Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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Rourke Art Education Course Intake Form
Part 2. Class Information
Class Title
*
Class Description
*
Description will be utilized in web and social media marketing.
Length of Class; Preferred Dates
*
Please provide multiple options as museum staff will have to consult its program and exhibitions calendar. We ask that courses are scheduled at least 2 months in advance. The Rourke prefers classes to overlap with its open hours (Friday-Sunday, 1-5) as much as possible, but can accommodate weeknights and full-day intensives. *Please email Cady, cady.rutter@therourke.org, for special considerations.
Age Requirement? Family-friendly?
*
Pre-requisite experience necessary?
*
What do students need to bring to class? Proper attire?
*
Class Supply / Equipment:
Will be provided by instructor
Will be purchased by student from supply list
Location Preference
*
Indoor
Outdoor
Other special considerations? Special set-up needed?
Price of Course (calculated per student)
Instruction fee + Supply & Equipment fee + Venue fee ($10 for 30-90 min. OR $20 for 2-4 hrs.) (includes processing, set-up, facilitator marketing, on-site course) = Total fee per student
Minimum # of Participants
Maximum # of Participants
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Rourke Art Education Course Intake Form
Part 3. Instructor Info
Tell us a little about yourself . . .
*
Bio/background info will be used in web and social marketing.
Class Promotional Photo
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