MOVE FOR A MISSIOn TEACHER INTAKE FORM Name * First Name Last Name ARTIST NAME Contact info * Please provide your best form of contact. DATES + TIMES AVAILABLE * List all of the dates + times you'd be able to teach a 1-hour class from November 15th - December 15th. LOCATION * What area(s) of Atlanta (ITP & OTP) would you prefer to teach in? We can't guarantee it, but we'll try out best. Style * What style would you prefer to teach? List as many as you'd like. Target age group * What age group would you prefer to teach? Select as many as you'd like. 18+ High School Middle School Elementary Social Media Handles We'd love to tag you to help promote! Thank you for joining the movement! We look forward to serving our community with you and will be in touch soon.