CE Classes – Scheduling Form

Name of Business by Design Course:

Interested in having us teach more than one class for you? Please submit a new form for each class request. Thanks!

Location Where Class is to be Offered? *

Month to Offer Class? *

Class Time? *

(note—allow at least 30 days so proper state registration can be done, do not advertise or promote your class until final approval is issued)

Audience You Intend To Target:

Sponsoring Business Name: *
(if teaming with other businesses, list all involved)

Owner Or Primary Contact’s Name: *

Business Phone Number:

Cell Phone Number:

Owner or Primary Contact’s E-mail:

Your Name: *

Your Role: *

Your Phone Number: *

Your Email: *