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GATEWAY MINIATURE FAIR SAMPLE OF YOUR CLASS IS PREFERRED, BUT A GOOD PICTURE OF THE ACTUAL CLASS TO BE TAUGHT IS ACCEPTABLE, AND MUST BE INCLUDED WITH THIS APPLICATION. YOUR CLASS WILL NOT BE CONSIDERED IF THESE REQUIREMENTS ARE NOT MET. PICTURES WILL BE USED FOR PROMOTING THE CLASS AND WILL NOT BE RETURNED. APPLICATION DEADLINE OCTOBER 12, 2013. IF YOU HAVE QUESTIONS, CONTACT LINDA GEARHART (llgear@sbcglobal.net). BUSINESS NAME__________________________________________________________ TEACHER________________________________________________________________ ADDRESS_________________________________________________________________ CITY/STATE/ZIP____________________________________________________________ PHONE________________________________E-MAIL______________________________ WORKSHOP TITLE__________________________________________________________ FULL DESCRIPTION OF WHAT THE STUDENTS WILL LEARN AND WHAT THEY WILL DO IN CLASS. ____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ IF SUBMITTING MORE THAN ONE CLASS, PLEASE DUPLICATE THIS FORM AND SEND IN A SEPARATE FORM FOR EACH CLASS. SOME REGISTRANTS WANT TO PURCHASE THE KIT TO TAKE HOME, THEREFORE, ALL KITS SHOULD CONTAIN A SET OF DIRECTIONS. A FEE WILL BE ADDED TO THE PRICE OF EACH CLASS TO HELP DEFRAY THE COST OF THE CLASSROOM RENTAL. PLEASE READ CAREFULLY AND BE SURE TO CIRCLE THE CHOICES. TIME PREFERENCE: ALL DAY 9 AM-NOON 1 PM - 4 PM CLASS SIZE: MINIMUM_________ MAXIMUM_________ COST OF CLASS $________ SKILL LEVEL: BEGINNER INTERMEDIATE ADVANCED SCALE: 1INCH 1/2 INCH OTHER___________ STUDENT SUPPLIES NEEDED____________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ YOUR SPECIAL NEEDS: WATER? ____________ ELECTRICITY?______________ OTHER_______________________________________________________________________ USE SAMPLE AS AUCTION/DOORPRIZE:
YES__NO___VALUED AT_________ PLEASE REMEMBER TO RETURN THIS FORM ALONG WITH A SAMPLE OR GOOD PICTURE FOR YOUR CLASS TO BE ACCEPTED. (YOU CAN E-MAIL A COPY OF THE PICTURE TO Fay Zerbolio (FZerb@aol.com) Send to: Joanne Martin, 324 George, Kirkwood, MO 63122 (314) 822-7322 - JEM324g@att,net SIGNATURE_________________________________DATE____________________________ |