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2. First Name*
3. Last Name*
5. Address*
6. City*
7. Zip Code*
9. Day Phone Number*
10. Email*
14. Class Name*
16. Class Description*
18. Class Space Requirements*
20. Class Level(s) Offered
21. Maximum/Minimum Participants*
23. Do you have a business license?*

    1. Yes
    2. No
24. If yes, what is your Tax ID?*
26. Preferred Season*

    1. Winter/Spring (January to May)
    2. Summer (June to August)
    3. Fall (September to December)
    4. Year Round
28. Preferred Day(s) of the Week
29. Preferred Class Time(s)
31. Class Location(s)*

    1. Chambers Creek Regional Park (9850 64th St. SW, University Place)
    2. Frontier Park (21800 Meridian S., Graham)
    3. Heritage Recreation Center (9010 128th St. E.)
    4. Lakewood Community Center (9112 Lakewood Dr. SW, Lakewood)
    5. Meridian Habitat Park and Community Center (14422 Meridian E., Puyallup)
    6. North Lake Tapps Park (2022 198th Ave. E., Bonney Lake)
    7. Spanaway Park (14905 Bresemann Blvd. S., Spanaway)
    8. Sprinker Recreation Center (148224 S. C St., Tacoma)
    9. Other
33. If other, please list park site and/or address
35. Instructor Pay Request*
37. Additional information/notes related to proposed class
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39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field