New Student Registration Form

Student Online Registration Form

Welcome! If you are a new to our organization, please fill out this form. Use the arrows to expand each section below, when finished, click the "Submit" button.

PERSONAL INFORMATION
Your Name *

First Name Last Name
Gender *

Male Female N/A
Adults, ages 16 & up (or accompanied by a guardian) are welcome to register. Tell us your Birthday (Month, Day & Year).
Your Date of Birth *

Month Day Year
Date Picker

CONTACT INFORMATION
E-mail Address *
Primary Phone Number *
Best way for the instructor to contact you regarding class? *
Email Updates?

Yes, subscribe me to the monthly newsletter.
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

EXPERIENCE
Skill Level? (Check one)

Absolute Beginner - never taken an art class before Beginner - has taken at least one art class before Intermediate -solid understanding of drawing or painting Advanced - mastered drawing or paiting
What is your medium of choice?
You may list multiple mediums

IN CASE OF EMERGENCY
Please contact *

First Name Last Name
At this phone number *

Area Code Phone Number
Relationship to Emergency Contact
i.e. Who are we contacting?

SPECIAL REQUIREMENTS
I have special needs that requires an accommodation. *

No Yes
If yes, please explain
(i.e. wheel chair access, service dog, etc.)

READY TO SUBMIT
Should be Empty:

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