Invitation to Belonging - Intake Form
There is no fee for this program.
To register, participants must complete the Invitation to Belonging Intake form.
Email address
Participant Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Participant's Mailing Address
Street Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Participants E-mail address
Your answer
Phone Number
Your answer
Organization Affiliation (if applicable)
Your answer
Parent/Guardian Information
Parent/Guardian Name
Your answer
Mailing Address
Your answer
Email
Your answer
Phone Number and/also Emergency Contact Number
Your answer
The following questions are to be answered by the participant.
Describe your experience in the arts:
Your answer
Please list 2 personal goals for the week of Invitation to Belonging?
Your answer
Are there any specific art practices or ideas that you are eager to explore this week?
Your answer
Is there anything else you want us to know about you?
Your answer
How did you hear about the Young Dance Invitation to Belonging?
Your answer
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