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SciArt Club Waitlist 26-27
Fill out this form to add yourself to the SciArt Club waitlist. We will contact you if a spot opens up! -Mrs. Eads & Mrs. Peipert
Student Name
*
First Name
Last Name
Grade Level
*
Please Select
3rd Grade
4th Grade
Homeroom Teacher
*
Please Select
Clegg
Valeriano
Hawbaker
Cary
Haverkamp
Fielder
Havener
Cashman
Castor
Ellis
Daniel
Parent or Guardian Name
*
First Name
Last Name
Parent or Guardian E-Mail
*
example@example.com
Parent or Guardian Phone Number
*
Format: (000) 000-0000.
Which session does your child wish to attend if a spot opens up?
Please Select
Session 1: October 16th-November 20th
Session 2: January 22nd-February 26th
No Preference
Additional Comments (Allergies, etc.)
Submit
Should be Empty: