Educator Application Form

Educator Application Form

Please fill in the form below. Fields marked with a red * are required, others are optional.
Full Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
What is your medium?*
Some examples: painting, macrame, jewelry, sculpture, etc.
FacebookInstagramNone
List your social media handles for Facebook & Instagram:
Upload your headshot and/or photos of your work*

We use this for promotional materials.
Cancelof
Upload your headshot and/or photos of your work

We use this for promotional materials.
Cancelof
Upload your headshot and/or photos of your work

We use this for promotional materials.
Cancelof
Class Title*
Class Description*
Class Length*
In hours. Example: 1 = 1 hour, 1.5 = 1 hour and 30 minutes
Class Cost*
In USD. Example: 00.00, 27.50
Audience Age or Grade Level*
Example: 16+, 18+, K-5th grade, K-12th grade
For classes audiences under the age of 16 HCA policy states that a guardian must remain on premises during the duration of the workshop or class. Instructors teaching minors must provide background checks to HCA.
Audience Skill Level*
Max Class Size*
Enter a number for how many students you are comfortable teaching. HCA has 35 chairs available.
Supplies Educator will Provide:*
Please list any supplies you will bring for your students to use.
Supplies Students need to bring:*
Please list any supplies students need to bring with them to attend this class.
At the end of class what should learners be able to do?*
Examples: General understanding of weaving by setting up a loom, reviewing weaving patterns, and ultimately creating a sampler scarf on a loom.
Any other details about the class you would like us to know? Please list any special accommodations here.
Examples: Age of class participants, Particular days you would like the class on, How long the workshop will last in weeks, etc.
The gallery manager will contact you for any additional information required and potential class dates. Thank you for your interest in teaching a class or workshop at Harrison County Arts.
Should be Empty: