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.
You can make a difference:
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms