Parent's Name _____________________________________________ Phone Number ________________
Street Address ____________________________________________________________________
City, State, Zip ____________________________________________________________________
email address ____________________________________________________________________
If you were refered by someone, please let me know:_______________________________________
2. What is your favorite type of artwork? (ex. drawing, painting, sculpture) ________________________________________________________________________________________
3. On another sheet of 8 1/2" x 11" paper, submit a piece of artwork completed by you of anything you would like to draw & in any medium you would like to use (ex. color pencil, crayon, watercolors, etc.).
4. Just using a pencil, draw a picture of yourself below.