City of Burbank Parks & Recreation Department Contract Class Instructor Interest Form
Express an interest in offering a class by completing this form in order to be added to our interested instructor list and we may be in touch with you if an opportunity becomes available to submit a proposal for consideration. Class interest forms will remain on file for one year.
INSTRUCTOR INFORMATION
Name
*
First Name
Last Name
Business Name (If applicable)
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Website (If applicable)
www.example.com
CLASS INFORMATION
Do you have your own facility to hold class at?
*
No
Yes (must be located in the City of Burbank)
Title of class
*
Brief description of class
*
(No more than 75 words)
0/75
Title of class #2
Brief description of class #2
(No more than 75 words)
0/75
Please describe specific training that would qualify you to teach the class/classes:
*
Please explain why you believe that your proposed class/classes would be a benefit to the Burbank community:
*
References
Please list three (3) references:
Name
*
First Name
Last Name
Title and Company
*
Title
Company
Phone Number
*
Please enter a valid phone number.
Name
*
First Name
Last Name
Title and Company
*
Title
Company
Phone Number
*
Please enter a valid phone number.
Name
*
First Name
Last Name
Title and Company
*
Title
Company
Phone Number
*
Please enter a valid phone number.
I authorize you to contact these references regarding my application:
*
Yes
No
Submit
Should be Empty: