Crochet Project 2025

Crochet Project
Crochet Class with Mrs. A

Do you want to learn how to crochet?

Already crochet & want to learn more?

Sign up to recieve:

Yarn

hook

Treats

Attend Virtual Sessions on Wednesday nights 6 to 7 pm on March 5, 12 & 19th

Questions? Carolyn@eocinc.org or 570-331-6755
Name*

First NameLast Name
Email*
example@example.com- prefer not school email
Student's Date of Birth

MonthDayYear
Date
Address for delivery*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Please enter a valid phone number- texting is needed.
Current School*
I am a:*
Current Grade*
Ethnicity*

WhiteHispanic or LatinoBlack or African AmericanAmerican Indian or Alaska NativeAsianNative Hawaiian or other Pacific IslanderMore than one race reported
Please tell us what career or college major you are considering or would like more information on: *
Student Signature: I understand that I am signing up for a paint & sip and will receive supplies and log on to the activity*

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Parent/Guardian Name*

First NameLast Name
Parent or Guardian Phone number*
Please enter a valid phone number.
Parent Email Address*
example@example.com
Parent 1 Highest Education Completed*
Parent 2 Highest Education Completed*
Household Taxable Income*
Household Income is*
This is in reference to the Household Taxable Income in the question above.
Snacks are included in the activity bag-Please add if your child has allergies & cannot receive snack items:
Parent Permission and Signature: My signature indicates that I give permission for my child to participate*

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Should be Empty: