register SEA workshop — LORENZO NASSIMBENI

PLEASE FILL IN THE FORM BELOW IF YOU ARE INTERESTED IN ATTENDING FUTURE WORKSHOPS.

Name of participant

Surname of participant

Email address of participant

Mobile number of participant

Name of legal guardian

Surname of legal guardian

Email address of the person responsible for payment the workshop fee

*This is for the purposes of communicating with the person responsible for payment of the workshop fee.

The name of your school

What grade are you in?

Grade 10

Grade 11

Grade 12

Instagram handle

Permission to publish artwork

* We publish participants' artworks created during the workshops on our social media platforms and website. Participants who grant us permission to share their artworks will be fully credited.

Yes

No

Which of the following subjects do you take at school?

Art

Design

Engineering Graphics & Design (EGD)