Youth Outreach Program Application Name Preferred Pronoun: Date of Birth: Age: Phone (Cell) Phone (Home) Street Address: City: Province Postal Code: Email: School: Grade: First Emergency Contact Name: First Emergency Contact Phone Number: Second Emergency Contact Name: Second Emergency Contact Phone Number: Allergies: Where did you find out about the Youth Outreach Program? Why are you interested in taking the Youth Outreach Program? What would you like to learn and achieve from the program? Describe your experience with art making. Please choose your preferred day to attend the program: TuesdayThursdayEither Tuesday or Thursday ***Please attach 3 examples of your artwork, in any medium: Apply Now! What's On / What's Next Subconscious Terrain // Tracy Peters April 17, 2021 Virtual Artist Talk: Scott Benesiinaabandan March 3, 2021 Futures Barren/Futures Abundant // April Dean February 18, 2021 Martha Street Studio Relief Effort – Print Exchange January 28, 2021 Inversion // Jill Ho-You December 17, 2020 Martha Street Studio response to COVID-19 March 18, 2020