Usdan Summer Camp for the Arts

New Inquiry Form 2022

Parent's First Name *

Parent's Last Name *

Parent Email Address *

Parent Phone Number *

How many children are you interested in enrolling? *

Student 1's First Name *

Student 1's Last Name *

Grade ('21-'22) *

Primary Interest *

Student 2's First Name *

Student 2's Last Name *

Grade ('21-'22) *

Primary interest *

Student 3's First Name *

Student 3's Last Name *

Grade ('21-'22) *

Primary interest *

Student 4's First Name *

Student 4's Last Name *

Grade ('21-'22) *

Primary interest *

Address *

Address Line 2

City *

State *

Zip Code *

Would you like to share anything else with us?

Please let us know how you heard about us. (select all that apply) *

Are you a Usdan alum?

No

Yes

Years attended

Maiden name (if applicable)

Date of birth +

Friend Referral	Teacher Referral
Parent is an Alum	Facebook
Instagram	Mommy Poppins
New York Metro Parents	New York Family
Google Search	Uniquely U Scholarship Search
Other