Program Submission Form - Summer 2022 Please enter the information for your class in the form below, including attaching an image file for your class. Once submitted, a copy will be sent to the Studio Leader and Arts Director, and you will also receive a copy for your records, sent to the email you provided. Jansen Art Center 321 Front Street Lynden, WA 98624 [email protected]PROGRAM INFORMATIONStudio* Ceramics Dance Jewelry Music & Theatre Paint & Fine Arts Textiles Instructor Name* Class Title* Class Description*Prerequisites Prerequisites needed No prerequisites List any prerequisites Age Group*Kids (6-12)Youth (10-14)Teens (13-18)Teens and Adults (13+)Adults (16+)Adults (18+)Adults (21+)Class Fee Materials Fee*Yes - Paid to the InstructorYes - Paid to the JNo Materials FeeAmount of Materials Fee, if applicable Materials the students will need to bringClass ImagePlease provide an image for use on our website and for additional marketing to promote your class. Drop files here or Select files Max. file size: 128 MB. Class Start Date* MM slash DD slash YYYY Class End Date* MM slash DD slash YYYY Day of the Week Class Dates - List the dates of each class MM/DD Class Time Begins:* : Hours Minutes AM PM Class Time Ends:* : Hours Minutes AM PM Number of Sessions Ex: 4 week class, meeting once a week = 4 sessions Total Class Hours Cut Off Date for Minimum Registrations *Default is noon the day before class.Last Date for Additional Registrations *Default is noon the day before class.Minimum Class SizeMaximum Class SizeRoom RequestedCeramics StudioAlley WorkshopJewelry StudioTextiles - Front RoomTextiles - Back RoomEnsemble RoomPainting StudioLibrary WorkshopVirtualSpecial Requests & Additional NotesINSTRUCTOR INFORMATIONName First Last PronounsShe/HerHe/HimThey/ThemAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Website Email PhonePre-approved instructor compensation per hourInstructor imagePlease provide an image for your bio on our website. Drop files here or Select files Max. file size: 128 MB. Instructor/Artist bioNew instructors, or instructors wanting to update their information. Δ
