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2. Applicant Information
4. Name
6. Email
7. Phone Number
11. Program Information
13. Program/Class Name *
17. Describe the Program/Class*
19. Program/Class Type*

    1. Youth
    2. Adult
    3. Senior
    4. Other
20. Proposed Season*

    1. Spring (March - May)- Deadline Oct. 15
    2. Summer (June - August)- Deadline Jan. 15
    3. Fall/Winter (Sept. - Feb.) - Deadline April 15
22. Participant Age Range*
23. Registration Fee*

    Contract classes are a 70/30 split with the City. Please list the fee that you would like to be paid.

25. Min # enrolled*
26. Max. # enrolled*
28. Perferred Day of Week*

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday

    1. Friday
    2. Saturday
    3. Sunday
30. Perferred Time of Day*

    1. 8 a.m. to Noon
    2. Noon to 4 p.m.
    3. 4 p.m. to 9 p.m.
31. Length of Class*

    1. 30 minutes
    2. 1 hour
    3. 1.5 hours
    4. Other
33. Course Dates*
34. Number of Classes per Session*
36. Perferred Locations*

    1. Community Center
    2. Hometown Heroes Park
38. What equipment and/or supplies would you like the Recreation Department to provide for this program (including tables, chairs, audio-visual equipment, screens, etc.)?*
40. What equipment and/or supplies would the participant need to have in order to participate?*
42. Qualifications
44. Please list previous experience in providing this type of class or program. *
46. List other qualifications, certifications, and/or trainings. *
50. Submitting a program proposal doesn't guarantee that the program will be added. Program proposals may take up to 4 weeks to process. After your proposal has been reviewed, a program coordiantor will contact your in regards to the status of your program.
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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field