TMJ YATA 2020 - 2021 Registration
Please complete this form to register for the 2020-2021 TMJ Young Artist Training Academy

Upon completing this form, please return to our website to submit your uniform investment for the academic year.
Email address *
Student Artist Name ( Last, First, MI) *
Student Artist Age *
Student Artist D.O.B. (55/55/5555) *
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Student Artist Street Address *
Student Artist City *
Student Artist State *
Student Artist Zip Code *
Student Artist School District *
Student Artist School Name: *
Student Artist Grade Level *
Parent/Guardian Name (Last, First, MI) *
Parent Guardian Address (If Different From Student Artist)
Parent Guardian Email *
Parent Guardian Phone (555-555-555) *
Secondary Phone (555-555-555) *
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