Youth Summer Camp Interest Form
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1. Contact Information for interested applicants
1
. Please provide some background information that will help us understand our target audience.
Please provide some background information that will help us understand our target audience.
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Country:
Email Address:
Phone Number:
2
. Which Youth Summer Camp are you interested in?
Which Youth Summer Camp are you interested in?
1 week Studio Production (M-F)
2 week Field Production & Editing (M-F)
5 week Studio Production (Saturdays)
6 week Field Production & Editing
3
. Why are you interested in this camp and what do you want to learn?
Why are you interested in this camp and what do you want to learn?
4
. What days & hours work best for you (or your parent’s schedule)?
What days & hours work best for you (or your parent’s schedule)?
Mon- Friday 12:30-5:30
Saturdays 10 am - 2 pm
Saturdays 1 pm – 5 pm
5
. Education Background
Current Grade level
Elementary School
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12
Freshman
Sophomore
Junior
Senior
Graduated
Education Background Elementary School Current Grade level
Middle School
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2
3
4
5
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12
Freshman
Sophomore
Junior
Senior
Graduated
Middle School Current Grade level
High School
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2
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5
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10
11
12
Freshman
Sophomore
Junior
Senior
Graduated
High School Current Grade level
College
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12
Freshman
Sophomore
Junior
Senior
Graduated
College Current Grade level
College Degree?
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