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North Shore School of the Arts Student Interest Form

Please fill out the form below.
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First Name:*

Last Name:*

High School:*

Grade:*

Parent or Guardian Name:*

Address:*

City:*

State:*

Zip:*

Home Phone:*

Work Phone:

Cell Phone:

Email: *

Parent/Guardian Email:

Alternate Email:

Choose area of Interest:*

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Music
Theatre
Visual Arts
Non-Credit Summer Workshop

Instrument(s) if Music:

Choose Preferred Location:*

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Southeastern's Main Campus, Hammond
Southeastern's St. Tammany Center, Koop Drive, Mandeville
Southeastern's Livingston Literacy and Technology Center, Walker

How did you learn about the NSA? *

Optional Information:

Future course suggestions:

Preferred day(s) and time(s):

Comments or Questions:

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