KickStart Application Name First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneGrade Birthdate MM slash DD slash YYYY School District Shop Parent InfoParent Name First Last Parent PhoneParent AddressIf different than student's Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code ApplicationWhy do you want to participate in Kickstart?Do you have a special talent or business idea? Please describe.Are you interested in a leadership role? Please describe.What are your future career/education goals?Can you participate in the Summer Program at the Hoyt? (Tuesdays and Thursdays, July 5-August 16 from 10am - 1 pm; Plus August 12th for all day event) Yes No Can you commit to attending every Monday during the school year at LCCTC, 3-6 pm (September 12-May 22)? Yes No Text RemindersYes! I would like to receive text reminders about this activity and information about other activities like it. I consent to receiving SMS messages from Arts & Education at the Hoyt. Standard Message and data rates apply. Photo Release(Required)I herby grant Arts & Education at the Hoyt, its representatives and employees the right to photograph or video me/my child in connection with this activity. I authorize Arts & Education at the Hoyt, its assigns and transferees to copyright, use and publication of the same in print and/or electronically for any lawful purpose, including publicity, illustration, advertising, and web content. I agree to the photo release policy. I do not agree to the photo release policy.
