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First Name
Last Name
Email

Are you willing to have us contact you with any questions?

Yes
No

Do you want to be notified if this course is offered?

Yes
No

Please describe (in detail) your vision for a new course.

Are you a previous Community & Continuing Education student?

Yes
No

What day of the week would you like to take this class?

What would be the ideal time of day for this class?

Would you prefer this course be held in a classroom, online, or both?

How much would you be willing to pay for this class?