Digital Art & Technology Access Registration
Thank you for registering for Digital Art & Technology Access (DATA)! Space is limited, once this form is submitted, you will receive an email within 72 hours with confirmation of your space in the workshop.

Class schedule:
Sound workshop with artist Zain Alam: March 15 and 17
Tuesday and Thursday 4-6 pm
@ Squeaky Wheel, 617 Main Street, Buffalo, NY 14202
Cost: free

3D Animation 1: March 26–April 30 (No class April 16)
3D Animation 2: May 7–June 11 (No class May 21) * taking 3D Animation 1 is not required to participate in 3D Animation 2, but is encouraged.  
Saturdays 11 am–2 pm
@ Villa Maria College, 240 Pine Ridge Rd, Buffalo, NY 14225
Cost: free

If you have any questions or need assistance filling out this form, please email martina@squeaky.org

*All information is confidential and for internal use only

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I'd like to register for the following workshop(s) [please check all the workshops you'd like to register for]
Student Name *
Student Age *
Current School and Grade Level *
Any allergies or medical issues that we should be aware of? (we will be providing light snacks, please note any food allergies or restrictions below) *
If "yes," please specify.
Things the student likes *
Things the student dislikes *
Student has experience in filmmaking
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Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email *
Home Zip Code *
Emergency Contact Name and Phone number (if same as parent/guardian write N/A) *
Is the student currently receiving services from the Office for People With Developmental Disabilities (OPWDD)? *
If no, would you like to learn more about applying for services through the Office for People With Developmental Disabilities (OPWDD)? *
How did you find out about DATA? *
I grant to Squeaky Wheel/Buffalo Media Resources the right to take photographs/video of family members and workshop participants in connection with this workshop. I authorize Squeaky Wheel/Buffalo Media Resources Inc., its assigns and transferees to copyright, use, and publish this media in print and/or electronically. I agree that Squeaky Wheel/Buffalo Media Resources Inc. may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content. *
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