Pre-College Core Studio Concepts Registration

Effective Semester

Student Information

Name*

First Last

Gender Identity*

Male
Female

Please select your gender or specify preferred gender identity.

Date of Birth*

Do you consider yourself to be Latino(a) / Hispanic?

Yes
No

In addition, please select one or more of the following racial categories to describe yourself:

Native American or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Non-Resident Alien

Student Email

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

School Name*

Graduation Year*

Parent Information

Parent Name*

First Last

Parent Email*

Parent Home Phone*

Parent Work Phone*

Class Selection

Will you be attending in-person or online?

Please Select 1 (one) online course*

Online Core 2D Design Studio
Online Core Fine Art Studio

Please Select 2 (two) in-person courses*

Fiber Arts (waitlist)
Graphic Design (waitlist)
Illustration (waitlist)
Painting (waitlist)
Photography (waitlist)
Screen Printing (waitlist)
Basic Observational & Figure Drawing (waitlist)

Student will be staying in MIAD's residence hall?*

Yes
No

Roommate Request

Scholarship Applications

I will be applying for a DPI scholarship

Registration Deposit

Price: $50.00

Total

$0.00

Due Later:
$1450

Due Later:
$2315

Due Later:
$1225

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

I would prefer to receive my registration paperwork electronically

If this is not checked, you will receive your registration paperwork in the mail.

Name

This field is for validation purposes and should be left unchanged.

Pre-College Core Studio Concepts 2021

Student Information

Parent Information

Class Selection

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