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Instructor
Contact
(if different from above)
Address Street City/State Zip
Email Telephone (Home) Telephone (Mobile)
Instructor certifications,
education, experience, etc.
Name of Course
Goal of Course
Course Description
Required equipment,
supplies to be purchased
by student
Day of week/time
Number of sessions
Dates of sessions
(Including holidays)
Minimum number of Maximum number of
registrants Registrants
A/V Equipment
required
Cost for Course
