Art Class Registration Form
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Which class are you taking?
First Name *
Last Name *
Are you a People's Resource Center Client? *
If yes, what is your PRC Client ID Number?
How did you find out about our virtual art classes?
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What is your date of birth? *
GG
/
MM
/
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Address *
Apartment
City *
Zipcode *
Phone Number *
Other Phone Number
Email address *
Gender *
What country were you born in?
What is your first language? *
Race
Ethnicity
Highest Level of Education
Income Sources (check all that apply)
Employment Status
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Approximate Total Monthly Household Income
Avanti
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