AYW Student Application
First and Last
Name of School
Arts College Preparatory Academy Middle School
Arts IMPACT Middle School
Bexley Middle School
Buckeye Middle School
Calumet Christian School
Champion Middle School
Columbus Adventist Academy
Columbus Performance Academy
Columbus School for Girls
Columbus Torah Academy
Dominion Middle School
Edison Intermediate and Larson Middle School
Gahanna Christian Academy
Hilltonia Middle School
Horizon Science Academy
Johnson Park Middle School
Kilbourne Middle School
Madison Christian School
McCord Middle School
Medina Middle School
Metro Early College Middle School
Mifflin Middle School
Northside Christian School
Ridgeview Middle School
Sherwood Middle School
Summit Academy Middle School
Tree of Life Christian Schools
Wedgewood Middle School
Westmoor Middle School
Whitehall Prep and Fitness Academy
Woodward Park Middle School
Worthington Christian Schools
Yorktown Middle School
Parent/Legal Guardian Name
First and Last
Parent/Legal Guardian Phone Number
Parent/Legal Guardian Email Address
Any dietary restrictions?
Which Saturdays are you available to attend?
November 2nd 11-2 at Pizzuti Gallery
Have you been bullied?
Yes, I was bullied once.
Yes, I have been bullied multiple times in the past.
Yes, I am currently being bullied.
If yes to the above please describe your experiences.
Has a bully physically hurt you? Did you remain silent? Did you tell an adult?
Do you enjoy being creative? What are some of your favorite creative outlets?
I grant to You Will Rise Project the right to take photographs of me and my artwork in connection with the above-identified event. I authorize You Will Rise Project to use and publish the same in print and/or electronically. I agree that You Will Rise Project may use such photographs and video of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content. I have read and understand the above.
Yes, I give permission for my child to be photographed.
No, I do not give permission for my child to be photographed.
Stonewall Columbus is an all inclusive non-discriminatory public space in Columbus Ohio.
I understand that Stonewall Columbus does not discriminate based on sexual orientation, gender identity, and gender expression. That all children and volunteers will be welcome to participate in the Art Your Way Foundation Workshops as a safe space (all volunteers must pass background check).
Yes, I understand and give my consent.
No, I do not give my consent.
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