SCA College of Svatý Sebesta
        Instructor & Class Information

Please Complete and Send to: Registrar of Svatý Sebesta
PO Box 1  Vermillion SD  57069

Please Print Legibly                                                              Date:                             

Instructor's SCA Name:                                                                                                                       

Instructor's Mundane Name:                                                                                                               

Address:                                                                                                                                                

                                                                                                                                                              

Phone:                                                                                                                                                     

E-mail:                                                                                                                                                    

Title of Class:                                                                                                                                          

Brief Description of Class:                                                                                                                       

                                                                                                                                                              

                                                                                                                                                              

How much time do you need for the class (50 min periods)                                                                      

What supplies will students need to bring?                                                                                                

Will there be a materials fee?  How much?                                                                                                 

Do you wish to restrict the size of the class? If so, how many students?                                                      

Do you have any special needs for this class:  (electricity, AV equipment, wet space, , etc.)                                           

                                                                                                                                                                 

Session you are will to teach at:                                                                                                                

Would you be willing to teach this class at other sessions?                                                                         

Rec'd by Registrar:  ___________     Confirmation Sent:  __________   Chancellor Fwd:  __________

                                                                                                                                                                     Form Revision Date:  March 29, 2002