Instructor Interest Form

First Name*

Last Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Education/Degree (Click all that apply)*

Art classes you are able to teach (Click all that apply)*

If a class was not included above, please share any additional class types you can teach.

Preferred length of program to teach (Click all that apply)*

Preferred ages to teach (Click all that apply)*

Seniors (62+)
Adults (27 - 61)
Young Adults (18 - 26)
Teens (13 - 17)
Children (7 - 12)
Young Children (3 - 6)

Please select the populations you have had experience teaching (Click all that apply)

If a population was not included above, please share any additional groups of people you have worked with.

Please explain what the arts mean to you and why you would like to teach at the Academy.

What year was your last background check completed? Please enter N/A if you have never had a background check done.*