Name

Sex M F

Birth Date

Mailing Address
Street

Apt #

City

State

Zip Code

Phone No.

Email Address

Formal Education

Present Position

Experience with children

Indicate your location preference(s) below.

Ecker Hill International School, Wednesdays, from 4-6:00 pm

Jeremy Ranch Elementary, Tuesdays, from 3-5:45 pm.

Jeremy Ranch Elementary, Wednesdays, from 3-5:45 pm

McPolin Elementary, Tuesdays, from 3-5:45 pm

Parley’s Park Elementary, Thursdays, from 3-5:45 pm

Trailside Elementary, Wednesdays, from 3-5:45 pm

North Summit Elementary (Coalville), Thursdays, from 2:15-5 pm

North Summit Middle School (Coalville), Mondays, from 2:30-5:00 pm

South Summit Elementary (Kamas), Mondays, from 3:00-5:45 pm

Please tell us why you want to participate in this program?

Do you consider yourself flexible and open?

Yes No

Will you agree to facilitating or aiding a process under the guidelines established for ARTS-KIDS which are person-centered and experiential rather than product perfect?

Yes No

Please name two character references and phone numbers

I will attend training for the program. (See the current schedule for date and time)

initial