YAE! Young Artists Empowerment

Youth's First and Last Name*

Age & Grade*

School*

Child's Address*

Name of Parent/Guardian*

Parent/Guardian Phone Number

Parent/Guardian Email Address*

Household Annual Income*

Parent/Guardian Statement of Need - Tell us more about how the participant would benefit from a YAE! Camp scholarship?*

Future YAE! Camper - Why do you want to attend YAE! Camp?*

I agree that the information provided above is truthful and accurate to the best of my knowledge and ability. *

Agree Do Not Agree