Summer Workshops Interest Form

Please submit your name and contact information to be included in future Converse summer programs mailings and to receive additional information about the Summer Workshops.

Interest in workshops:	CSI Converse Converse Theatre Workshop Visual Arts Workshop Young Writers Workshop Fine Arts Day Camp
Name of Student:
Name of Parent:
Mailing Address:
City:
State:
Zip:
E-mail:
Phone:
How did you hear about these Converse Summer Workshops?	Newspaper Online From Friend Counselor Other
If other, please specify: