ÆTHELMEARC INSTRUCTOR INFORMATION FORM

1. SCA Name:

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2. Mundane Name:

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3. Street:

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4. City, State & Zip:

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5. Telephone number:

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6. E-mail Address:

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7. Home Group:

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8. Class Title:

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9. Class Level: (Beginner, Intermediate, Advanced)

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10. Class Length: (1 hour, 2 hour, 3 hour)

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11. Class Description:

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12. Supplies student should bring to class:

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13. Materials fee for this class (if any):

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14. Maximum number of students:

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15. Special facilities required (electric, tile floor for messy class, sink, large tables, outdoor area, etc.):

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16. Event Registration: (Select event name or general registration only.)

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17. General Registration: Regions you are willing to travel to teach this class. (Check all that apply. Registrants may be contacted to teach at events in regions selected below.):

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This Information form will be kept on file with both the Arts and Sciences Office and the Æthelmearc Æcademy. We would like to start a database of Instructors in Æthelmearc. The information will be made available to Class Coordinators for Æcademy Sessions, local Scholas, Colleges, Universities, etc. In Regions where you have indicated you are willing to teach. This information will be kept on a web site accessible only by the Staff of the Æcademy and the Kingdom Minister of Arts and Sciences. Our goal is to find out who is available to teach and the kinds of classes that are available. By signing this form, or registering online with your name in the space below, you are giving permission for this Information to be kept on file and released as needed. We thank you for your time and interest! Master Remus, AEcademy Chancellor

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