Instructor Application

First Name(*)
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Last Name(*)
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Address(*)
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City(*)
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State(*)
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Zip(*)
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Preferred Phone(*)
Use format 123-456-7890

Cell Phone
Use format 123-456-7890

E-mail(*)
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Please give as much information as possible on the technique or method for your class.(*)
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Please give us a list of your fees for the class, as well as all other expenses we are to cover.(*)
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