Year 12 Visual Arts: Application Form | Campbelltown Arts Centre

Applications Due: 5pm, Thursday 27 June, 2019

Year 12 Visual Arts: Frames & Unseen Works
Saturday 29 June, 9am - 12pm

This is a FREE program, but places are limited.

Please complete the following application form prior to 5pm, Thursday 27 June to join the program at Campbelltown Arts Centre.

C-A-C will contact you and your parent/carer on the Friday (or earlier for early applicants) to confirm whether you have been accepted for this program.

Enquiries and more information:

Feel free to contact Edwina Hill, Education Officer either over the phone, email or face to face, for more information or to discuss different ways to apply.

Edwina Hill
Education Officer
(02) 4645 4298 | 0419 213 872
[email protected]

Name*

First

Last

School

Grade

Do you identify as Aboriginal and Torres Strait Islander?

Yes

No

What is your cultural background?

Suburb

Phone

Area Code

-

Phone Number

E-mail*

Please include any medical requirements, allergies or access needs that might affect your participation in the program. This information is for planning purposes only.

Dietary Requirements

How did you hear about this program? (Please include teacher's name if applicable)

Why would you like to join the Saturday intensive, for Year 12 Visual Arts students at Campbelltown Arts Centre? *

Is there anything you'd like us to cover in the course?

How would you like to use your creative arts skills in future? (e.g. career, study, projects you'd like to undertake) *

Name *

First

Last

Phone *

Area Code

-

Phone Number

E-mail

Name *

First

Last

Phone *

Area Code

-

Phone Number

Photo Permission
I do hereby grant permission to Campbelltown City Council c/- Campbelltown Arts Centre to use the image and likeness of my child as outlined below:

Recordings and images from this program may be edited and used to publicise and promote Campbelltown Arts Centre, or as part of reporting requirements for funding.

Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of participants (including Your Child) for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Campbelltown City Council and Campbelltown Arts Centre website.

This permission applies to workshops, performances and other activities conducted by C-A-C. I acknowledge that if at any stage I no longer wish for My Child’s images to be used, I will notify the Arts Centre in writing via email to [email protected]

*

Accept

Don't Accept

DISCLAIMER:
The personal information provided on this application form will be used and disclosed by Campbelltown Arts Centre for general administration and communication, or for any purpose required or permitted by law. This information will be held securely and disposed of when no longer needed.