Name *

First Name

Last Name

Date *

MM

DD

YYYY

Phone *

(###)

###

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Please check top three areas of art study: *

Visual Arts 2D

Visual Arts 3D

Performing Arts Theater

Performing Arts Music

Digital Arts Film

Digital Arts Photography

Check if you agree: *

I am able to commit to 2-4 hours per week for 3-6 months on my apprenticeship.

I am interested in a career as an artist or performer..

I will commit to attending the final performance/exhibition if I am able.

If I qualify for Vocational Rehabilitation, I am open to using those services to assist with the funding of this apprenticeship.

I understand that this is a paid apprenticeship only if I participate in Vocational Rehabilitation.