Offer A Course Please complete and return your course proposal form to the Springfield Parent Academy (Address below). You must complete a Course Provider Proposal Form for each course that you plan to provide. Thank You! Organization’s NameOrganization Contact PersonEmail PhoneCourse InformationBrief Course DescriptionCategory of Course Student Achievement Finances/Budgeting Health & Wellness Parenting Personal Growth Instructor NameAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Course will/can be presented in what language English Spanish Other Intended maximum class sizeDo you have a specific target audience?Estimated duration of workshop (Maximum 90 minutes per course)Thank you for your submission!Springfield Parent Academy Contact Information Address: 91 School St Springfield, MA 01105 Email: info@springfieldparentacademy.com Phone: (413)787- 6959 Fax: (413) 787 - 6692Important Information for Course Providers All course providers are subject to maintaining the privacy and confidentiality of all participants. Please note there can be no exchange of personal information or selling of any products during the course. Print Form
