2021 Andy Harvey Workshop Application
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LAST NAME *
FIRST NAME *
What is your phone number? *
Please provide your email address: *
What is your parent's or guardian's name *
Please provide your parent's or guardian's phone number: *
Please provide your parent's or guardian's email address: *
How old are you? *
What is your street address? (Please include city and zip code) *
Name of your school: *
Your year at school as of the Spring 2020 semester: *
How did you hear about the workshop? *
If chosen will you be able to travel to and be picked up from Flagstaff as well as live in Flagstaff for a week? *
What is your tribal affiliation? (Preferred but not required to attend workshop)
Tell us why you would like to participate in the workshop: *
The following questions will be used for those students chosen to participate in the workshop:
The following questions will be used for those students chosen to participate in the workshop:
If chosen for the workshop, do you feel that you are responsible enough to follow directions of workshop staff and keep yourself occupied safely during “down time”? Please explain. *
Do you have a computer and internet access with reliable WiFi at home? *
Are there any limitations or anything else you'd like to tell us about your computer and WiFi at home?
Please indicate a roommate request if you have one:
What is your gender identity? *
Do you have any health issues that you or your parents feel will be important for us to be aware of? *
Please list any food allergies: *
What is your preferred t-shirt size? *
There is a $50 tuition fee. If chosen, are you able to pay the tuition amount before the workshop? (If not,  briefly explain why you are unable to pay; there are full scholarships available.) *
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