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Kirkwood Community Center - Contract Instructor Interest Form
Use this form to propose a contract class or program at the Kirkwood Community Center. Completion does not guarantee placement or a contract.
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Email *
Contact Information
Full Name *
Business/Organization Name (if applicable)
Address *
Phone *
Email *
Website or social media (optional) 
Program Proposal
Proposed class or program title *
Program type (check all that apply) *
Required
Brief description of your program (2–4 sentences, as it could appear in our brochure/online) *
Target audience (age group and skill level) *
Estimated class size *
Schedule and space needs
Preferred session (check all that apply) *
Required
Preferred days and times
Preferred start date / season (e.g., Spring, Summer)
Desired room type (check all that apply) *
Required
Experience and qualifications
Briefly describe your relevant teaching/instruction experience
Certifications, licenses, or training related to this program (e.g., fitness certifications, CPR/First Aid)
Have you taught this or a similar class before?
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Business details and logistics
Are you proposing to teach as:
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Proposed session length (e.g., 6 weeks, 8 weeks)
Class duration (minutes per class)
Any materials/supplies participants must bring or purchase
Proposed class fee per participant (if known)
Are you comfortable with a standard revenue share in which the Kirkwood Community Center retains 30% of gross program fees and the contractor receives 70%, understanding that we are open to discussing alternative contractual arrangements if needed?
I certify that the information provided is true and understand that submitting this form does not guarantee a contract or placement in the Kirkwood Community Center program schedule *
Required
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