Class Request for Website

Class Request for Website
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Are you an Education Coordinator (EC)? *

Yes No
Class Name *
In the cass description include a short description of the class and who it is availible to i.e. only ALS. How will registration work? Is the class once a week for months or a weekend event? If someone has questions who should they contact?
Description of the Class *
Start Date *

Month Day Year
Date
at
Hour Minutes AM/PM Option
End Date *

Month Day Year
Date
at
Hour Minutes AM/PM Option
Registration Link (If doing online registrations)

Where will the class be held? *