Teacher Proposal Form

Northwest Hoosier Basket Guild 4th Retreat
September 30 - October 2, 2010
Valparaiso, IN 46383

Please use an address label or print clearly

Name _______________________________________________________________

Address _____________________________________________________________

City_________________________________ State ___________ ZIP ___________

Phone__________________________Email __________________________________

Proposed Basket/Class Information

Name of Basket _______________________________________________________________

Weaving Level: (Please circle one) All    Beginner    Intermediate    Advanced

Measurements: Width:______  Length:______  Height w/handle:______  Height w/out handle:______

Class Size: Minimum Class Size:_________   Maximum Class Size:_________

Description of basket or weaving project: (Please include any special techniques or skills that will be utilized/taught in class. Please list embellishments/liners/lids/etc. that will be included. PLEASE BE BRIEF. Use box below:

Special Tools Required: _______________________________________________________________

Extra Space Needed: _________________________________________________________________

Total Class Hours: (circle one) 2 hours      4 hours      6 hours      8 hours     other_____

Cost of Class (include cost of materials AND teaching fee: _____________________

Minimum # of classes you will teach: total classes or hours _____________________

Maximum # of classes you will teach: total classes or hours _____________________

If you are accepted to teach, do you wish to vend? (circle one)    Yes    No

    Booth spaces are 8' deep x 10' wide @ $40/per space - Electric is available.

Will you be participating in Marketplace (if not vending) (circle one)    Yes    No

We would like for you to include a short biography of your basket weaving and/or teaching experience.

I give my permission to the Northwest Hoosier Basket Guild Fall Retreat to include a copy of my submitted basket photo along with the class description and fee on their website for the purpose of this event. I also understand that if I send my photos by mail they will not be returned to me.

Signature:________________________________________  Date: _______________________

Mail proposals (to be received by January 23, 2010) to:

JoAnn Lawrence
33 N 575 E
Valparaiso, IN 46383

Phone: (219) 462-7711

jolawrence@peoplepc.com

Please feel free to submit as many proposals as you wish, but please use a separate form for each proposal.
Feel free to duplicate this form as needed.