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  1. Phone number and email of requesting person
  2. Type of course
  3. In Detail explain your request from above. If other put course type requesting and details of needs.
  4. Please insert Date/Time for the course requested.
  5. Please give physical location and address of where you would like the class to be instructed.
  6. Explain what the instructor will need to bring. ie Computer, projector, etc.
  7. Leave This Blank:

  8. This field is not part of the form submission.