Middle School Sewing and Textile Summer Enrichment Program 2021 Registration Form

JavaScript ei ole teie brauseris lubatud ja seda faili ei saa avada. Lubage JavaScript ja laadige uuesti.

Come explore your creative side with sewing!

This is a beginning level class, but students with some previous sewing experience are welcome to participate and build on their current skills.

Participants will get to experience both hand stitching and machine sewing in this small group, social setting.

• Use a sewing machine
• Hand sew
• Applique/patch
• Operate specialty tools
• Follow a pattern to complete project
• Design project elements

Students will be provided all materials for the course as needed.

Teacher: Katie Bushnell
Dates: August 2nd - August 5th
Times: 9:00am - 12:00pm
Location: Madison Middle School
Grades: Students going into 6th-8th grade for the upcoming school year

Edenemise salvestamiseks logige Google'isse sisse. Lisateave

Student's LAST Name *

Student's FIRST Name *

Student's 4J Identification Number

Middle School Student Will Be Attending in FA2021: *

Arts and Technology Academy

Cal Young Middle School

Kelly Middle School

Kennedy Middle School

Eugene Online Academy

Madison Middle School

Monroe Middle School

Roosevelt Middle School

Spencer Butte Middle School

Muu:

Student Home Address: *

Example: 200 N Monroe St., Eugene, OR 97402

Parent / Guardian Last Name: *

Parent / Guardian First Name: *

Parent/Guardian Email *

Parent/Guardian Phone Numbers - Cell, Home, Work *

Please list all available numbers. Examples: 541-790-7700 (Cell) 541-790-7701 (Home) 541-790-7702 (Work)

Name of Emergency Contact : *

Emergency Contact Relationship: *

Example: Grandmother, Aunt, Family Friend, etc.

Emergency Contact Phone *

Example: 541-790-7700

Health Conditions: Please indicate if any of these or other conditions apply to your child.

Asthma (please list more specific information below)

Diabetes (please list more specific information below)

Heart Condition (please list more specific information below)

Hearing Loss (please list more specific information below)

Orthopedic Condition (please list more specific information below)

Mobility Limitation (please list more specific information below)

Severe Bee Sting (please list more specific information below)

Seizures (please list more specific information below)

Severe Food Allergy (list which food or foods below)

Speech Disorder (please list more specific information in prompt below)

Other Allergies (please list more specific information in prompt below)

Muu:

Please indicate if your student is supported by

IEP

504

As appropriate, please provide more specific information on health conditions, including required accommodations.

If the student requires prescription medication while attending this Summer Intensive Course, please list.

Järgmine

Tühjenda vorm

Ärge saatke paroole kunagi Google'i vormide kaudu.

See vorm loodi domeenis 4j.lane.edu. Väärkasutusest teatamine

Vormid