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.
Format: (000) 000-0000.
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 90 day 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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