BotanicWise • BotanicWise

BotanicWise

Women's Herbal Gathering

September 15-17, 2023

Teacher Survey

We're excited to hear from you! This in-person event will be held at the Kempton Community Center, 83 Community Center Dr, Kempton, PA 19529, on September 15-17, 2023. Please know that while completing this application puts you on our potential teacher list, it does not guarantee a slot in our current or future events.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Provide your best email for us to reach you!

Business Name

What is your preferred method of contact?

Your Website and Social Media

Website

Facebook

Instagram

Your Work and Availability

Please provide a summary of your work *

Are you available to teach in-person (if conditions allow) at the BotanicWise Women's Herbal Gathering on September 15-17, 2023? *

Are you willing to be recorded (video and/or audio) at the event? *

Are you willing to be interviewed before the event? *

Are you willing to teach via Zoom if necessary? *

This event will be in-person, but a pre-event interview would be held via Zoom.

If you are BIPOC, do you have any suggestions for the conference organizers?

Are you interested in learning about future teaching opportunities? *

If possible, give 2-4 class title/descriptions (classes are 90 minutes) for us to review:

Concise Bio:

Bio pic (highest resolution possible please) *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Would you like to be a vendor?

Yes
No
I'd like to learn more about vending

Additional comments or suggestions

Phone

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