Request a Class
Please consider offering classes on:
1st Request:
2nd Request:
Thank you for your request, you will be contacted by e-mail if the class is offered.
Requester Information:
Name:
Contact Number:
E-mail Address:
Name of Class
Date of Class:			Session: AM PM	Other:
U.S.D. 261 Employee?		Select Yes or No Yes No
If yes, where do you work?:		Select A Building Administration Building Alternative High School Campus High School Haysville Middle School Haysville West Middle School Freeman Elementary Learning Center Maintenance Nelson Elementary Oatville Elementary Prairie Elementary Rex Elementary Ruth Clark Elementary TriCity Day School Transportation Other: I teach grade(s):
If no:		Place of Employment:
Address:		Address of Employment:
		City:	State:	Zip:
		Information will be sent to THE LEARNING CENTER