How familiar are you with the Burlington Area Community Education Program? Please select one: 

 These ADULT EDUCATION CLASSES have been offered during the past 2 years. Please select the courses you would be interested in if offered again:

 The following classes have been popular in other Community Education Programs. Please select any courses you would like offered in our programs: 

 These ADULT RECREATIONAL ACTIVITIES have been offered during the past 2 years. Please select those activities you would likely participate in if offered again: 

 These adult recreational activities have been popular in other Community Education Programs. Please select the activities you would like to have offered here:

 These PEE WEE CLASSES/CAMPS have been offered during the past 2 years. Please select those activities which you would likely participate in if offered again (only parents of preschoolers need respond):

 These pee wee classes/camps have been popular in other Community Education Programs. Please select the activities you would like to have offered here:

 These CHILDREN/YOUTH EDUCATIONAL ACTIVITIES have been offered during the past 2 years. Please select those activities you would likely participate in if offered again:

 These children/youth educational activities have been popular in other Community Education Programs. Please select the activities you would like to have offered here:

 These CHILDREN/YOUTH RECREATIONAL ACTIVITIES have been offered during the past 2 years. Please select those activities you would likely participate in if offered again: 

 These children/youth recreational activities have been popular in other Community Education Programs. Please select the activities you would like to have offered here: 

 Any additional comments or suggestions on the cooperative City-School Community Education Program would be appreciated.

 If you wish to teach a class, or know of someone who would, or know of someone you would like to see teach, please list the class, name and phone number. Note: Instructors are paid for teaching. 

 What other projects would you like to have Community Education involved in?

 Name: 

 Phone: 

 Address: