Class Registration Register below for our 2024 Summer Workshops. For more information regarding this workshop CLICK HERE Minerva Summer 2024 Please register for our Summer workshops below. Please fill out one form for each student if registering multiple students. For any questions, or to inquire about a scholarship, please contact Cassi @ info@minervaartscenter.org. Student InformationStudent Name* First Last Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age*Please enter a value between 0 and 99.Name of Parent or Guardian* First Last Email* Phone*Secondary Email (optional) Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency InformationEmergency Contact Name* First Last Emergency Contact Phone #*Alternate Emergency Contact Name AND NumberAllergies or Other Medical Conditions?*YesNoDetails*Do you wish to provide more information that may be helpful in an Emergency*YesNoStudent's Primary PhysicianPreferred Hospital for Emergency treatment if necessary?SchedulingKnown or Possible Schedule Conflicts2024 Summer Workshops*Design WorkshopLittle to BigCheck OutTotal $0.00 I want to pay workshop tuition...*... now with PayPal... later with a check (Checks payable to Minerva Arts Center.)...pay by invoice or payment planPhoneThis field is for validation purposes and should be left unchanged.
