2022 Summer Music and Art Camp Application

2022 Summer Music and Art Camp Application

The ASU Summer Music and Arts Camp is designed to assist school-aged students from local and surrounding communities in improving skills in music and art. This specially planned three-week summer program will help students to strengthen their knowledge and practical application of Music and Art Performance Techniques and develop skills which will prove beneficial in future academic and life scenarios.

Completed form due by May 17, 2021

Program Overview

Program Dates: June 13 through June 24

Program Days: Monday through Friday

Program Time: 8 AM – 4 PM

Free Breakfast/Lunch*: 8:15 AM and 12 PM Daily

Final Camp: June 24

Performances and Exhibitions: TBD

Student Information

Student Last Name:*

Student First Name:*

Student Date of Birth:*

Student Age:*

Student Gender:*

Select

Home Street Address:*

Home City:*

State:*

Select

Zip Code:*

Preferred Email Address:*

Emergency Contact Phone:*

Phone

Please indicate which area student wants concentrated study:*

Music

Visual Arts

Is there anything you would like teachers, coordinators, or staff to know about this student?

Meals

*“Public School-type” breakfast and lunch will be served in the university dining facility for free. If the student elects not to accept the

provided lunch he/she will have a choice whether to purchase (at their own expense) the buffet style lunch at ASU student pricing

($8.00), purchase lunch at any of the chain restaurants on campus, or bring a lunch from home.

List any and all food allergies of student:*

Parent / Guardian Information

Parent / Guardian Name*

First and Last Name please

Workplace / Company Name:*

Work Phone:

Phone

Cell Phone:*

Phone

Parent / Guardian Email Address:*

Parent / Guardian Signature

If you have any questions about this application please call Dr. Ken Trimmins, Program Director @ 229-500-2217.

Parent / Guardian:*

By typing in my name, checking the box below and submitting this form, I am giving Albany State University authorization to care for my child during the hours of the Summer Music Camp.

Please check here for Authorization:*

Please Note:

All personal data and special categories of sensitive personal data collected or processed by Albany State University (ASU) must comply with the ASU Cybersecurity Program Plan, as authorized by the Board of Regents Policy Manual Section 10.4 Cybersecurity:

https://www.usg.edu/policies

Anyone suspecting his or her sensitive personal data has been exposed to unauthorized access, report your suspicion to:

LegalAffairs@asurams.edu

Otherwise, questions concerning GDPR can be forwarded to LegalAffairs@asurams.edu. Typing your name in the box below and submission of this application provides consent to and acknowledgment of the ASU Data Security and Privacy Policy.

Privacy Notice|Report Abuse

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.