Empower Hour Program Submission Form
Please submit this form so we have all the details necessary to add your program to the upcoming season.  Please complete 1 form per program.  So if you offer Kickball 2 different days, submit 2 forms, thank you!
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Name (First and Last) *
E-mail Address *
Cell Phone *
School (what school do you want to offer this program at)? *
What space in/at the school are you requesting? *
What do you need "in" the space? (Click ALL that apply) *
Required
Would you like to offer this Before or After School? *
Name of the Program? *
Are you a vendor/outside organization or are you an HVS staff member? *
If you are an outside vendor, what is the name of your organization?
Does HV Rec and Ed have a current W9 on file for your organization?
Clear selection
What days of the week do you want to offer? *
Required
What grades is this program for? *
Minimum Size for the class to run *
Maximum Size for the class *
Do you have a current contract with HV Rec and Ed with details about this program?  Typically we do a 50/50 split with the program. *
Please describe the program you want to offer, this will be used for the description online. *
Do you have any images you'd like to use to help show what this class is all about? *
Proposed Fee for the program? *
Any questions?
Submit
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