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Small Group Workshop Registration Registration
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* Indicates required question
Parent/Guardian Name
*
Your answer
Email
*
Your answer
Phone number
*
Your answer
Address- Street
*
Your answer
Address- City
*
Your answer
Zip Code
*
Your answer
Are you a member of the Lyman Allyn Art Museum?
*
Yes
No
Student- Name, Age, Grade Level, Pronouns
*
Example: Sarah, 8, 3rd grade, she/hers
Your answer
Additional Student- Name, Age, Grade Level, Pronouns
Example: Sarah, 8, 3rd grade, she/hers
Your answer
Additional Student- Name, Age, Grade Level, Pronouns
Example: Sarah, 8, 3rd grade, she/hers
Your answer
Demographics (optional)
Demographic information is used for grant assistance to support new educational opportunities, reduced cost or free programs, and other museum initiatives.
Asian/Asian American
Black/African American
Hispanic/Latin(o,a,x)
Native American/American Indian/Native Hawaiian/ Other Indigenous Group
White
Multi-Racial/Multi-Ethnic
Other:
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