APPLICATION FORM

DEADLINE: FEBRUARY 20, 2023

Important Note

It's a good idea to pre-write the long answers in a separate document then copy and paste them in to ensure they are not lost if this page is closed by accident. Once you submit this application, it will be automatically emailed to KIAC at programs@kiac.ca. If you do not receive a confirmation email from within 3 business days, please contact us at (867) 993-5005.

PARTICIPANT INFORMATION

Full Name *

First

Last

Age *

Participants must be 14-18 years of age at by March 22, 2023. If you are 13 years old -but- are in grade 9, you CAN apply.

Current Grade *

Have you participated in Youth Art Enrichment before?

Yup!
No, this is my first time!

Gender *

Male
Female
Non-Binary/Other (please detail below)

This is for hotel room assignment only. Participants from outside of Dawson share a room with 1 - 2 others in the program and safety and comfort are a priority.

Student Email

If you do not have an email address, please leave this section blank. We will send important information via a parent or guardian.

Address *

Address Line 1

City

State / Province / Region

Postal Code

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone Number *

Home or Cell

Relation to Applicant *

(i.e parent, grandparent, aunt/uncle, etc)

OTHER INFORMATION

To be filled out by parent or guardian

Allergies and/or Special Dietary Needs *

If the participant does not have any, enter "none". This section allows our cooks to prepare delicious meals that can be enjoyed by all students. If allergies or dietary restrictions (ie vegetarian, no dairy, etc) are not communicated here, we cannot guarantee that each meal will have a suitable option.

Other Needs or Considerations

Is there anything special our chaperones, instructors, and staff should know about the applicant's preferences, behaviour, or needs?

REFERENCE

In order to complete your application, you must provide a reference. This can be a teacher, community leader, mentor, etc, but CANNOT be a family member.

Reference's Name *

First

Last

Reference Contact *

Phone number and/or email

Relation to Applicant *

i.e school teacher, neighbor, mentor, etc.

Recommendation *

If the reference is hand written or pre-typed, either you or your reference can scan and email it to programs@kiac.ca.

INTRODUCE YOURSELF!

Tell us about your interest in the arts *

What art mediums or styles do you like? Do you have a favourite artist? What inspires you? What types of art would you like to learn in the future?

Describe your experience making art *

What mediums have you tried? What courses or programs have you taken part in?

Why do you want to participate in Youth Art Enrichment? *

There is no right or wrong answer, we're just curious!

WORKSHOPS

Participants will complete ONE workshop during the week. Please select your first, second, and third choice. Though we do our best to place every student in their first choice, this isn't always possible.

2D Studio Practice: Painting & Mixed Media with Aleks Bartosik *

First Choice
Second Choice

Description coming soon!

Act Your Mind: Theatre Creation & Performing Arts with Geneviève Paré *

First Choice
Second Choice

Join Geneviève Paré for an awesome adventure into the world of performing arts - no experience necessary! Learn the high art of goofing off! Through Improv games, theatre sports, and a dash of clown and puppetry, students will learn to make bold choices and embrace failure as a natural step towards hilarity. The week of unscripted silliness will culminate in improvised performance for peers. Participants will learn stage presence, improv, storyboarding, vocal expression, verbal and non-verbal story-telling and a whole lot more! Rumour has it that Gen even has experience in stunt wrestling and stage combat fighting!

SIGNATURE

Should my application be successful, I understand the following: *

A one-time fee is required to help cover programming and supplies, meals, transportation, and accommodation costs. I understand a spot in the program is not secure without payment. Fees are $50 for Dawson youth, and $150 for youth from all other communities.

Financial assistance for low income families is available, please see the link at the bottom of this page for details.

Should my application be successful, I understand the following: *

Full participation in the program is required. This includes daytime classes, evening leisure activities and meal times (breakfast, lunch, and dinner). Dawson youth may opt out of breakfast and dinner, though we strongly encourage as much participation as possible.

Should my application be successful, I understand the following: (copy) *

KIAC will arrange travel (chartered bus) and accommodations (hotel) for youth from Whitehorse and communities outside of Dawson.

Should my application be successful, I understand the following: *

Parent/guardian consent is required.

Name of Applicant *

Electronic Signature *

An electronic signature is simply a typed version of your signature

Current Date & Time *

Date

Time

Application Timeline

1. Following your application submission, you will receive a confirmation email within 3 business days.

2. Applications will be reviewed and processed as soon as possible.

3. Applicants will be notified of acceptance or waitlist status. Accepted applicants will be provided with additional paperwork (parental consent forms, student guidelines, and payment options) which is required to secure their spot in the program.

4. Forms and payment must be submitted by February 27th.

If you are submitting a hand written reference letter, don't forget to scan and email it to programs@kiac.ca!

Questions? Contact Devon at (867) 993-5005 or programs@kiac.ca. We look forward to hearing from you!

Phone

2023 Application

APPLICATION FORM

DEADLINE: FEBRUARY 20, 2023

Important Note

PARTICIPANT INFORMATION

PARENT/GUARDIAN INFORMATION

OTHER INFORMATION

REFERENCE

INTRODUCE YOURSELF!

WORKSHOPS

SIGNATURE

Application Timeline

If you are submitting a hand written reference letter, don't forget to scan and email it to programs@kiac.ca!

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