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Links September 07, 2010
Arts Expedition Application
Please refer to the Arts Expedition General Information and the Arts Expedition Locations links before filling out this application. If you have any questions, please contact the PAVAN office at 540-665-1294. Make sure all fields in the form are completed. If you would like a printable hard copy of the Arts Expedition 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
   
     
Parents: Only one camp will be offered this year:    
  Camp 1: July 19 – July 23 9 a.m. – 3:20 p.m.
 		    
 
Please indicate your choice.

 
PleaseNote: These are tentative locations; Submit your application and the PAVAN office will contact you after March 15 in regards to your location selections.
 
Sanders Corner Elementary School (Ashburn, Loudoun County)    
John Kerr Building, Shenandoah University (City of Winchester)  
Pinebrook Elementary School (Loudoun County)    
     
     
   
     
     
Parent/Guardian Statement
     
My child, , has my permission to participate in the 2010 Arts Expedition Day Camp(s) at the site indicated above. I understand 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 need to read, sign and return to the PAVAN office.
     
Click if you accept this agreement.
I accept these terms
     
Include the tuition check (made payable to PAVAN/LCPS) in the amount of $175 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 to 540-665-4598.
• The deadline for all Arts Expedition applications is May 15, 2010.
     
Thank you.
     
     
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