One moment please...
CLUB CHIPS Application
Contact Information
Name
*
First Name
Last Name
Email
Verify Email
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Date of Birth
*
(mm/dd/yyyy)
Phone
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone
*
Parent Guardian Email
Verify Email
What school do you attend?
*
What grade are in at school?
*
Address of Your School
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
What is your usual grade point average?
Do you have any experience in the performing or visual arts?
Acting
Singing
Playing Music
Dance
Creative Writing
Visual Arts (drawing, painting, sculpture)
Martial Arts
Other
Other art experience
List special activities that you participate in regularly that could limit your availability to work (sports teams, school plays, jobs, community service, etc.)
State what you think is the greatest health or safety concern for St. Louis youth and why.
*