2020 Afternoon Artists - HEARTS

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Gina Farasciano Fund
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School Authorization form

Please fill in and submit this form for the Afternoon Artists program lottery.
You will be notified by January 20, 2020 if you have been selected to participate.

* Indicates required field

Student Name *

First

Last

Parent's Name *

First

Last

Parent Email *

Parent Phone Number *

School *

Guggenheim Daly Salem Sousa Manorhaven

Grade *

Third Grade Fourth Grade Fifth Grade

Has your child previously participated in Afternoon Artists? *

Yes No

I agree to receiving marketing and promotional materials

Submit