Name:
Date of birth:
Address:
Home Phone Number:
Mobile Phone:
Work Phone Number or Fax:
E-mail Address:
Occupation:

Which workshop are you interested in attending (Marble Carving or Clay Sculpting)

and which session?
May (A), June (B), July (C), September(D) or October (E)?
Have you ever traveled internationally?

SCULPTING INFORMATION
Why are you interested in attending a marble carving workshop at artspace?

Have you ever attended another marble carving or clay modeling workshop?
Have you ever used electric or pneumatic power tools?
Describe your sculpting experience.  

How many years have you been sculpting?
What mediums have you used? 

If you haven't sculpted before, what other artistic experiences have you had?

HEALTH HISTORY
Do you have any serious medical conditions? If so, please explain.

Do you take prescription medication?   What type and how often?

Do you have allergies to food, medication, dust, plants, insects or other?

Do you have any physical limitations that would prevent you from participating in the workshop?

EMERGENCY CONTACT INFORMATION
Name
Address
Phone Number
Alternate Number
Relationship

ACCOMMODATION PREFERENCES
What is your accommodation preference?  Please explain in detail.

Will you have a guest with you? If so, what is their name and relationship to you?

Do you have any special needs or requests in terms of accommodations?

What will the length of your stay in the accommodation be?

Other comments and concerns:

Click the button to submit this information to artspace!

Cellphone: +39 349 619 8600

from the U.S. dial 011 39 0584-772-101