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: *

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