Language
English (US)
Spanish (Latin America)
Application Form
RISING LOAVES at the Lawrence History Center, 6 Essex Street, Lawrence, MA 01840
June 29 - July 27, 2026
Program held Monday through Friday from 9 a.m. to 2 p.m. at the Lawrence History Center. Note: Program closed on Friday July 3, 2026 in observation of Independence Day.
Name
*
First Name
Last Name
Date of Birth / Fecha de nacimiento
*
Please select a month
January
February
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Please select a day
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Day
Please select a year
2026
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Year
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Cell Phone Number
*
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
Current school
Grade in September 2026
*
5
6
7
Photo Release: I give the Lawrence History Center permission to publish my child’s photograph and first name only on its web site, social media and in print materials for the promotion of the program to students and their families.
Yes
No
Permission of Parent or Guardian
I give my child (named above) permission to participate in the Lawrence Student Writers Workshop at the Lawrence History Center (including participation in walking tours around the the Lawrence North Canal district and one or two field trips by bus to the Addison Gallery of American Art on the campus of Phillips Academy in Andover, MA).
Name of Parent or Guardian
*
First Name
Last Name
Signature of Parent or Guardian/Firma de madre/padre/apoderado
*
Submit Online Application
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