Full Name (required):

Age (required):

Street Address (required):

City (required):

State (required):

Zip Code (required):

Your Best Phone (required):

Your Email (required):

Parent/Guardian Name (required):

His / Her Best Phone (required):

His / Her Email (required):

School in Fall (required):

Grade in Fall (required):

What neighborhood do you live in? (required):

Ethnicity:

Sexual Orientation:

Family Income Level:

How would you get to the program?

—Please choose an option—BUS/BARTCARWALK

How did you hear about the Summer Arts Apprenticeship? (please check all that apply)

FriendTeacher / CounselorFacebookFormer ParticipantYouth OrganizationOther

If Youth Organization, which one?

If Other, please list

The Summer Arts Apprenticeship requires a full commitment of time and energy and a minimum of 80 hours. Can you commit to attending ALL the sessions?

YESNO

Is there anything that would prevent you from attending?

ESSAY QUESTIONS:
PLEASE ANSWER ALL of the questions, in three sentences each.

1. What is your experience in dance or performance?

2. What do you hope to gain from the Summer Arts & Activism Apprenticeship?

3. What type of activism or issue are you interested in (i.e. immigration, education, health, community need, etc.)? Why is this issue important to you?

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