Program Submittal Form - Winter 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, who will get back to you. 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 INFORMATION1. Studio Selection* Ceramics Dance Jewelry Music & Theatre Paint & Fine Arts Textiles 2. Instructor name* 3. Class name* 4. Class description*5. Prerequisites Prerequisites needed No prerequisites List any prerequisites 6. Age group*Adults (21+)Adults (16+)Teens and Adults (13+)Teens (13-18)Kids (Specify ages below)Kids or Other - Specify age range 7. Class Fee, ($10-$15 per class hour is typical) 8. Materials Fee*Yes - Paid to the InstructorYes - Paid to the JNo materials feeAmount of materials fee, if applicable Materials the students will need to bring9. Class 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. 10. Day of week 11. Class start date* MM slash DD slash YYYY Class end date* MM slash DD slash YYYY Class dates - List the dates of each class DD/MM 12. Class time begins:* : Hours Minutes AM PM Class time ends:* : Hours Minutes AM PM 13. Total class hours 14. Number of sessions Ex: 4 week class, meeting once a week = 4 sessions, OR, list if the program is an ongoing class.15. Cut off date for minimum registrations* *Default is noon the day before class.Last date for additional registrations 16. Minimum class sizeMaximum class size17. Room requested Special request notesINSTRUCTOR INFORMATIONName First Last Pre-approved instructor compensation per hourAddress 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 PhoneEmail Instructor/Artist bioNew instructors, or instructors wanting to update their information. Instructor imagePlease provide an image for your bio on our website. Drop files here or Select files Max. file size: 128 MB. Website
