Program Application Extension for Existing Programs & Rentals

If you plan to request an extension for more than one class genre/rental, please fill out an application for each class individually, including all proposed extension/ongoing dates for each one.

Instructors Information

Instructor Name:
First Name

Last Name

Email

Phone
(###)

###

####

Business Name (if applicable)

Program Details

Brief description of what your class program offers:
Please use verbiage appropriate for branding; language will be used for social media platforms

Please select length of your program:

If you answered other above; please use this space to explain why

Dates of Class Program

Class Times

Min. students

Max students

Ages -/+

Price
$

I hereby acknowledge by submitting this form, that all of the above information is correct in its entirety.
Instructors signature:

Todays Date
MM

DD

YYYY

Thank you!

1600 Government St. Ocean Springs, MS 39564
Tuesday-Saturday 10-4
228-875-6732