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Links September 07, 2010
Artists In Bloom Application
Performing and Visual Arts, Northwest (PAVAN) will have applications available January 1 for its 2010 summer arts program: Artists in Bloom Day Camp. This fun arts program is for rising 1st, 2nd and 3rd grade students and involves art, music, creative movement, and theatre. This camp is open to all public, private and home-schooled students living in the surrounding counties of Virginia and West Virginia. If you would like a printable hard copy of the Artists in Bloom Application to send by mail (please do not fax) click here, and send to the address listed on the application.



Please enter the following information.
 
Applicants First Name:  
Last Name:  
Middle Initial:  
Gender: Male  
  Female  
     
Street Address/Box Number:  
Town/City:  
State:  
Zip Code:  
     
Parent/Guardian’s First and Last Name:  
Home Phone Number (with area code):  
Work Number(s) Including Extension:  
Parent’s Cell Phone:  
E-mail Address:  
     
Secondary Emergency Contact First and Last Name:  
Work Phone:  
Cell Phone:  
     
Applicant's E-mail Address  
Applicant’s E-mail Address (required) You will receive confirmation of PAVAN receiving your application via e-mail only.
     
My Residence is in:  
Age:  
Date of Birth: DD/MM/YYYY  
Current Grade (Seniors can not apply.)  
The school I am presently attending:  
     
My school is:    
  Public
  Private
  Home-Schooled
   
     
Submit your application and the PAVAN office will contact you in regards to your location options.
Sanders Corner Elementary School (Ashburn, Loudoun County)  
John Kerr Building, Shenandoah University (City of Winchester)    
Pinebrook Elementary School (Loudoun County)    
Waterford Elementary School    
     
Please indicate your SECOND choice.    
Sanders Corner Elementary School (Ashburn, Loudoun County)  
John Kerr Building, Shenandoah University (City of Winchester)    
Pinebrook Elementary School (Loudoun County)    
Waterford Elementary School    
     
Parent/Guardian Statement
     
My child, , has my permission to participate in the 2010 Artists in Bloom Day Camp at the site indicated at the top of this page. I understand that my child’s application must be complete in order to be considered for admission. I understand that shortly after I receive an e-mail confirmation from the PAVAN office stating it has received my child’s application and payment, my child and I will receive a handbook and medical forms which I will read, sign and return to the PAVAN office.
     
Click if you accept this agreement.
I accept these terms
     
Include tuition check (made payable to PAVAN/LCPS) in the amount of $100 with this application by May 15, 2010.
• Return both pages to the PAVAN office: 203 S. Cameron St., Winchester, VA 22601, attention: The PAVAN Office. You may also fax the application: 540-665-4598.
• The deadline for all Artists in Bloom Day Camp applications is May 15, 2010.
     
Thank you.
     
     
 
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