Date

Name

Date of Birth

Email

Phone Number

Mailing Address

Program of Interest

• Painting

• Sculpture

• Photography

• Graphic Design

• Mixed Media

Highest Level of Education Completed

• High School Diploma

• Associate Degree

• Bachelor’s Degree

• Master’s Degree

Preferred Payment Method

• Debit Card

• Credit Card

• Bank Transfer

• PayPal

• Cash

How did you hear about us?

• Online Search

• Social Media

• Friend/Family Recommendation

• Flyer/Advertisement

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