Application Form

Full Name

First Name Last Name

Address:

Street Address

Street Address 2

City State Postal / Zip Code

Phone Number:

Area Code - Phone Number

Current High School

E-mail

Which program are you interested in? (rate in order of interest)

Design 1 2 3

Film 1 2 3

Music 1 2 3

What is your level of computer experience?

Which computer programs have you used?

Why are you interested in MAPS?

Learn New Skills Have Fun Make New Friends Possible Career Other

If other, please describe:

How did you hear about MAPS?

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