Spectrum Arts Fall 2017 Application
Spectrum Arts Fall session begins September 18th. Please fill out the form and one of our staff will follow up to answer questions and give further details.
Student First Name *
Your answer
Student Last Name *
Your answer
Student Age *
Your answer
Student Birthday *
Your answer
Student Identifies as: *
Please check all that apply
Required
Student Cell Phone
If N/A leave blank.
Your answer
Student Email
Student emails will only be used by instructors to share class updates and materials.
Your answer
Student Address, City, State, Zip Code *
Your answer
Art Program 1st Choice *
Required
Art Program 2nd Choice
Guardian 1 Name *
Your answer
Guardian 1 Phone Number *
If you have more than one relevant phone number (Cell, work, etc.) please list them here
Your answer
Guardian 1 Email *
Your answer
Guardian 1 Address *
Guardian 2 Name
Your answer
Guardian 2 Phone number
If you have more than one relevant phone number (Cell, work, etc.) please list them here
Your answer
Guardian 2 Email
Your answer
Guardian 2 Address *
Does this student have any health concerns we should be aware of? *
Your answer
Does this student have any known allergies or dietary restrictions? *
Your answer
Will lack of transportation block your student from coming to Spectrum Arts Programs? *
Is there anything else we should know about this student?
Your answer
Emergency Contact Name *
If we are not able to get a hold of either Guardian 1 or Guardian 2, who should we contact?
Your answer
Relationship to Student
Your answer
Emergency Contact Phone Number *
Your answer
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