Donation

Young Writers’ Studio Registration

Please read the information sheet before registering:

Program Information
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Student Information

Please have a Parent / Adult Responsible for the Student complete the online Registration Form.
Student Name
(Optional)
Which school do you attend?
Which grade are you in?
What hour do you have English class?

Parent(s) / Adult(s) Responsible for Student

1. Parent/Adult Responsible for Student
2. Parent/Adult Responsible for Student (optional)

What Days Will Your Student Attend?

Program Dates
Select all days your Student will attend. The Program Runs Monthly on Tuesdays from 3:15-4:45pm.

Transportation

Transportation TO the Alden B. Dow Home and Studio

Consent

Parent / Adult Responsible for Student, please complete this section.
Student may receive emergency medical treatment if necessary.
I give permission to photograph the student and use images for publicity.
I confirm my student will be picked up from the Alden B. Dow Home and Studio at 4:45 pm by one of the adults listed on this registration form.
  • 315 Post Street, Midland, MI 48640
  • (866) 315-POST | (989) 839-2744
  • info@abdow.org

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