VALT Application Form

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Interested in signing up? Enter your information below. (Please note there are multiple pages.)
Participant Information










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Participant Demographic Information

Participant demographic data help Juxtaposition Arts develop programs, secure funding, and improve our work serving the community. This information is optional and is NOT used to determine acceptance to JXTA programming, for identification, nor is it shared with external parties. We appreciate your support in providing us with this optional information. While all questions are required you can choose the option "I don't want to answer"



If not currently enrolled in school, please enter "N/A"






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Travel, Accommodations, and Health