** ALL APPLICATIONS MUST BE COMPLETED ONLINE**

To be held at the University of Arkansas Pulaski Technical College (UAPTC)
3000 W. Scenic Dr.
North Little Rock, AR

Film Camp Student Application
April 22 - 26, 2024

A teacher or parent may need to help complete this application.

Film Camp is open to juniors and seniors in high school who have disabilities.

Film Camp registration is limited (50). Applicants will be reviewed and accepted on a first come, first served basis (as long as grade criteria is met).
Priority registration will be given to first time attendees.
   
If you have attended Film Camp on-site previously and want to attend again, you must apply now and you will be placed on a waitlist at the time of application.
After the deadline, April 1, we will determine if there are open slots for second year attendees. If you are on the waitlist you will be notified of acceptance and will need to confirm acceptance by April 4.
**If you make hotel reservations before your registration is accepted, please make sure the reservations are refundable (in case we don't get to your name on the waitlist).
The cost to attend for students is $75.00 which will help cover materials and daily lunch and snacks.  
Please complete all parts of this application.

For further information, contact Bonnie Boaz at (501) 375.6487.
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Please enter your first and last name.

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Please be sure to include the month, day and year: mm/dd/yyyy

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Please select your district from the list.

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Please enter first and last name.

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Please enter first and last name.

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(interpreter, wheelchair access, etc.)

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(Favorite activities, topics of interest, school program, community program, in school and/or private therapies, etc.)

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No one-on-one aides or personal care is provided at Film Camp.

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(Reads, uses written notes to assist with auditory understanding, write, uses picture schedule or written schedule, etc.)

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(e.g. aggression towards classmates/adults, leaving areas without permission, tantrums, fighting, verbal abuse, refusing to complete work, verbal outbursts, self-harming)

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Payment for these rooms is the responsibility of the person reserving. No adult supervision is provided outside of camp hours and will not be provided for any students needing accommodations at the hotel.

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