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Troy-Hayner Cultural Center
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HOME
Classes
Exhibits
Music
More About
Happenings
Bookings
Printable Class Proposal Form
Mail your completed form to:
Hayner Classes; 301 West Main Street; Troy, Ohio 45373; Attention Leona Sargent
Online Class Proposal Form
This section provides information about you.
Next you will provide information about the class you would like to teach.
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Indicates required field
Your Name
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First
Last
Email
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Your Street Address
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Line 1
Line 2
City
State
Zip Code
Country
If we needed to mail something to you, what address would we use?
Best Phone Number
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Additional Phone Number
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Samples of Your Work:
We would like to see samples of your work. You may submit samples one of three ways:
1. If you have samples on a website please provide the website below.
Website (If applicable). If applicable.
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2. If you would like to email digital images you may email to Leona at:
3. If you have printed samples you may mail them to:
Hayner Classes; 301 West Main St.; Troy, Ohio 45373; Attention: Leona
Education, if applicable:
High School
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Major/Minor/Degrees
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Year of Graduation
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College or University
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Major/Minor/Degree
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Year of Graduation
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College or University
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Majory/Minor/Degree
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Year of Graduation
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Have you ever been convicted of or pled guilty to a felony or drug, theft, or sex-related offense? If so please explain.
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Please answer yes or no. If yes, please explain.
References (Mandatory):
Please provide 2 references that can speak to your teaching skills and/or knowledge of the subject.
Reference #1: Name and Information
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First
Last
[object Object]
Address
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Line 1
Line 2
City
State
Zip Code
Country
Phone Number
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Email
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Years Known
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Relationship
*
Reference #2: Name and Information
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Phone Number
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Years Known
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Email
*
Relationship
*
Class Information:
This section is for information about the class you would like to teach.
Class Title
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Brief Class Description
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Please Select One
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A Series (more than one day)
A Workshop (a one day class)
Preferred Day/s of Week
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Preferred Time of Day
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Length of Class (in hours or portions of hours)
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Student Ages (choose all that apply)
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Pre K
K - 3
4th - 6th
Teen
Adult
Parent and Child
Classroom Requirements (choose all that apply)
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Extra Ventilation
Throwing Wheel
Water
Electricity
Easel/s
Projector
Screen
White Board
Other (explain below)
Is there any other classroom equipment you might need? Please discuss below.
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What are the minimum number of students needed to make it worth your while to teach the class?
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What are the maximum number of students you would allow to be in your class?
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Class Fee (Per person, per series or workshop. This needs to include the 15% fee for Hayner)
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List any supplies that are included in the "Class Fee"
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If supplies would be an additional fee, please provide your supply fee per student:
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Please list any supplies that are included in the "Supply Fee"
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Now list any supplies that you would like your students to bring to class. (Enter "all supplies provided" if that is the case.
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Please discuss what you would like for your students to take away from the class?
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Please click the "Submit" button.
Your proposal information will be sent to Leona.
You should be hearing from her shortly.
Submit