Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
My mailing address is different from my physical address.
Yes
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been affiliated with HSS?
*
Please Select
1-3 years
4-10 years
11-20 years
20+ years
Prior teaching experience (select all that apply)
*
K-12 classes
college classes
youth outside school settings
adults outside college settings
online
in-person
none yet
Primary subject(s) teach/write in (select all that apply)
*
poetry
nonfiction / memoir
fiction
playwriting
songwriting
literature
Appalachian studies
HSS program teaching interest (select all that apply)
online classes / programming
in-person class / retreat
working with youth programming
General availability (select all that apply)
winter
spring
summer
fall
daytimes
evenings
weekends
weekdays
Compensation (select all that apply)
for financial compensation
for vouchers for HSS events, classes, or workshops
as a volunteer
What distance from your home could you commute?
*
Please Select
0 miles (online teaching only)
1-10 miles
10-25 miles
25-50 miles
51+ miles
Would you be willing to lodge on campus for events in Hindman?
*
Yes
No
Professional website and/or social media tags
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CV Upload
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Age (optional)
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less than 25
26-35
36-50
51-65
66+
Gender (optional)
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female
male
other
Race & Ethnicity (select all that apply; optional)
Asian
black
Hispanic or Latinx
native or indigenous
white
other
Other Demographics (select all that apply; optional)
disabled
LGBTQ+ community
military veteran
neurodivergent
ties to Appalachia and/or Kentucky
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