Your Name:

Email Address:

Phone Number (Optional):

Preferred Contact Method:
EmailPhone
Session Type (Select One):
Individual SessionGroup SessionSchool WorkshopCommunity WorkshopOtherOther (Please specify):

Preferred Date and Time for Session:

(Please note that scheduling will be confirmed after discussing availability.)
Participant Age Group (Check all that apply):
Children (5–12)Teens (13–18)AdultsMixed Ages
Art Themes or Focus (Optional):


Special Requirements or Needs (Optional):

Location for Session (Choose one):
In HomeAt SchoolCommunity CenterOnlineOther
Other (Please specify):

Do you have a preferred medium to explore?
PaintingSculptureMixed MediaDrawingNo PreferenceOtherOther (Please specify):

Additional Notes or Comments: