Chicago Participant Application 2019
Students will participate in a combined enrichment activity in Chicago. May 26-28, 2019, participants will visit public artworks, experience museums and explore Chicago. School coordinator: Sharon Casteel Miller, WMS Art Teacher
Email address *
Student LAST Name *
Student FIRST Name *
Gender for room assignment *
Grade currently enrolled *
Student: 1. Please explain how you would benefit from a trip to Chicago. 2. Please explain what your presence would add to the trip. *
Student Schedule 1st Period: (room & Teacher) *
Student Schedule Ace Block: (room & Teacher) *
Student Schedule 7th Period: (room & Teacher) *
Student T-Shirt Size (regular cut, adult T's) *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Parent/Guardian Email *
Parent/ Guardian Phone *
STUDENT Applicant: read the following information and check each box indicating you understand and support the statement. *
Required
PARENT: read the following information and check each box indicating you understand and support the statement. *
Required
Payment Schedule: Online Payments accepted and/or Check Payments (write student name on every check!). NO CASH ACCEPTED.
Upon selection for participation (you will be notified in person, note, email, and/or Remind), please make timely payments. Chicago needs our money! :)
PARENT: read the following payment information and check each box indicating you understand and support the statement. *
Required
Late Payments may cause a cancellation of services/activities in Chicago. PLEASE MAKE PAYMENTS ON OR BEFORE DUE DATE.
Anything else you would like to share?
Student: I understand and will abide by the information in this application. Type name below. *
Parent: I understand and will abide by the information in this application. Type name below. *
Trip Coordinator: Sharon Casteel Miller, Visual Art Teacher, WMS, scasteel@laca.org
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