Request to Host a Class
Would you like to host a class in your center? Use this form to send a request to USBC Coaching.
1.Class Type (Check all that apply)
2.Time of Year Requested (Check all that apply)
3.Center Name *
4.Your Name (First & Last) *
5.Contact Name at the Center (If not yourself)
6.City *
7.State / Province *
8.ZIP/Postal Code of the Center *
9.Your E-Mail Address (ex: jdoe@service.com) *
10.Your Phone Number (including area code)
11.Phone Number of the Center
12.Street Address of the Center
13.Approximate Number of Attendees
14.What is the best way and time to contact you?
Center Features
15.Do you have? (Check all that apply)
If you have selected Other, please list the feature(s) in the box below:
16.Other Center Features
17.Meeting Room Maximum Capacity (As a class room setting)
18.Any additional information or comments?
* Indicates Required Field