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Our Voices Student Application
Instructions: Please read and complete all sections of this form.
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Name of Student
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Your answer
Address, City, State and Zip code
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Your answer
Telephone number
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Your answer
Gender
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Male
Female
Other
School attending and grade
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Your answer
Race: ( optional)
African American
Caucasian American
Hispanic American
Asian American
Native American
Other: please identify
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Have you previously or are you currently studying the arts? If so please explain
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Your answer
Name of Parent /Guardian child resides with:
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Your answer
Telephone number and email of primary Parent/Guardian
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Your answer
2nd Parent/Guardian Name and Address:
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Your answer
2nd Parent/Guardian telephone # and email address
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Your answer
Emergency contact in the event that either Parent/Guardian can not be reached: List name, address, telephone and email address
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Your answer
STUDENT ESSAY: I am interested in the Our Voices program because:
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Your answer
How did you hear about Our Voices
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Your answer
If you know anyone else that may be interested in the program please give their name and contact information below:
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Your answer
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