CREATIVE EXPRESSION LORE & LIFE SKILLS (C.E.L.L.S) REGISTRATION FORM

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Creative Expression Lore & Life Skills (C.E.L.L.S) is a training program that offers career development using an art based curriculum; Visual Art Design, Entrepreneurship and Small Business Education, Employment Readiness Training, Network and Marketing tools, Community-based Peer Outreach Education and CPR Safety / First Aid Training.

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First Name *

Last Name *

Address *

Phone Number *

D.O.B *

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Related Pronouns *

Emergency Contact (Name / Number / Relationship) *

Alternate Emergency Contact (Name / Number / Relationship)

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What skills are you interested in? *

Graphic Design

Media Arts

Jewelry Making

Visual Arts

Other:

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