Arts In Reach Application
Teen Participant Information
Full Name *
Your answer
Home Phone #
Your answer
Home Mailing Address (Street, City, State, Zip Code)
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Participant Cell Phone #
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Participant Email
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School Participant Attends
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Current Age
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Date of Birth
MM
/
DD
/
YYYY
Current Grade (For summer programs please enter the grade you will begin in September.)
Your answer
Which AIR program are you applying to?
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Is this your first AIR program?
How did you find out about AIR?
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Please tell us why you would like to attend this AIR program:
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List other school activities, hobbies, and favorite things to do:
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Will you need help with transportation?
Would a parent/guardian be able to help carpool?
If you need help with transportation, which one of our van stops would work best for you?
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