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* 1. Thank you for your interest in our Work of Art Fellowship series at New York Mills Cultural Center.

APPLICATIONS ARE NOW CLOSED for this program. However, if you would like to be placed on a waiting list in case space opens up, please fill out this form.

Please note that priority will be given to applicants who can commit to all ten sessions. All workshops are free and made possible through a partnership between Springboard and New York Mills Cultural Center.

Sept. 11th, Oct. 9th, Nov. 13th
Dec. 11th, Jan. 15th, Feb. 12th
March 12th, April 9th, May 14th, June 11th

6:30 pm to 9 pm

Will you be able to attend all ten sessions? If you anticipate any conflicts, please explain.

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* 2. What is your name?

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* 3. Please list your address.

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* 4. What is your phone number?

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* 5. Please provide an email address if you regularly use one.

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* 6. Which Springboard workshops have you attended in the past, if any?

50% of survey complete.