Registration Form Summer 2016
• To enroll, please submit one registration form per student.
• Student accounts with an outstanding balance must be paid in full before registration can be processed.
Young Artist Information
First Name of Young Artist
Your answer
Last Name of Young Artist
Your answer
Is your young artist a returning student or new student at SOE?
Required
If new, how did you hear about us?
Required
Student Date of Birth
MM
/
DD
/
YYYY
Gender
Race
SOE gathers this information for the purpose of reporting to funding agencies.
Required
Name of School
Your answer
Grade Entering Fall of 2016
Required
Parent/Guardian Information
First Name of Parent/Guardian
Your answer
Last Name of Parent/Guardian
Your answer
Relationship to Student
Your answer
Street Address or P.O. Box
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Primary Phone Number
Your answer
Email Address
Your answer
2016 Summer Art Camp Sessions
Select the camps for which you are registering your young artist by checking the box(es) below. Please submit one registration form per student.
Grades 2 - 5
I'M AN ALABAMA ARTIST!
Grades 6 - 8
Grades 6 - 12
Payment
Payment is due two weeks prior to the first day of camp. SOE accepts checks and cash. Make checks payable to Space One Eleven and include the name of your young artist in the memo line. Mail or bring payment to Space One Eleven.
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