SBMA'S TEENFORUM APPLICATION
Email address *
Name *
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Street Address *
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City *
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Zip Code *
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Phone *
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Grade *
Age *
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School *
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Emergency Contact Name *
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Emergency Contact Phone *
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Emergency Contact Relationship to You *
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What are your hobbies and interests? *
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What kind of leadership experience do you have? Have you ever been a part of a board or committee? Explain. *
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What kind of programs would you like to see at the South Bend Museum of Art? *
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What kind of art do you like? *
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Can you suggest any changes or additions to improve the museum’s services to teens? *
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How do you think your skills could be of service to the museum? *
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Why would you like to be part of TEENFORUM? *
Your answer
If selected as a member of TEENFORUM, I agree that I will be committed to membership for at least one year, participate in monthly meetings with enthusiasm and respect, attend and participate in teen programs and events, and respond promptly to TEENFORUM email/phone communication. *
Your Typed Name Will Serve as Your Digital Signature *
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Date: *
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How did you hear about TEENFORUM? *
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