Kent Blossom Arts Intensives Summer 2023 Application

First Name *

Middle Initial

Last Name *

Date of Birth

Month *

Day *

Year *

Local Address

Local Street Address *

Address Line 2

City *

State *

Country *

Zip Code *

Phone Number *

Email Address *

Permanent Address (if different from Local)

Permanent Street Address

Address Line 2

City

State

Country

Zip Code

Student Status *

Have you ever attended KSU? *

Yes

No

Current KSU Student? *

Yes

No

Banner ID *

Is Blossom the only course you are taking this summer? *

YES

NO

Are you applying for Student Credit? *

GRADUATE

UNDERGRADUATE

NONE

If you are taking Grad Credit, how many Graduate Credits are you applying for? (1-6) *

Ethnicity

Regardless of your answer to the prior question, please indicate how you identify yourself. (Check all that apply.)

American Indian or Alaska Native (including all Original Peoples of the Americas)

Asian (including Indian subcontinent and Philippines)

Black or African American (including Africa and Caribbean)

Native Hawaiian or Other Pacific Islander (Original Peoples)

White (including Middle Eastern)

Other

Gender

US Citizen? *

Yes

No

If not a US Citizen, country of citizenship. *

Country of Birth

Native Language

If permanent resident, PR#:

Visa Status

Are you an Ohio Resident? *

Yes

No

County? *

If you have attended KSU before, give date & campus attended

From Semester *

From year *

To Semester *

From Year *

Campus *

If not already enrolled at KSU have you applied for summer admittance? For Graduate credit, you must apply to the Graduate School for summer 2023.

Yes

No

Have you ever participated in the Blossom Arts Program before? *

Yes

No

Please provide information on post-secondary (college) education OR provide relevant art training in box below.

	COLLEGE ATTENDED	DEGREE (IF ANY)	DEGREE DATE	ATTENDED FROM: TO:
1	COLLEGE ATTENDED	DEGREE (IF ANY)	DEGREE DATE	ATTENDED FROM: TO:
2	COLLEGE ATTENDED	DEGREE (IF ANY)	DEGREE DATE	ATTENDED FROM: TO:
3	COLLEGE ATTENDED	DEGREE (IF ANY)	DEGREE DATE	ATTENDED FROM: TO:

Other Relevant Art Training

**Must have an intermediate knowledge of the workshop applying for. This is not a beginners workshop.

**SUBMISSION OF UNDERGRADUATE TRANSCRIPT IS REQUIRED FOR ACCEPTANCE AT GRADUATE LEVEL UNLESS YOU RECEIVED YOUR UNDERGRADUATE DEGREE FROM KENT STATE UNIVERSITY.**

Have you ever been convicted of a criminal offense or have charges pending against you at this time, other than minor traffic violations? *

Yes

No

Have you ever been dismissed, suspended or placed on probation by any other college or University for a non-academic reason? *

Yes

No

Do you have any kind of fee waver? If so please describe...

KENT BLOSSOM 2023 PROGRAM SELECTION

May 18, 2023 - May 31, 2023

Cost of workshops:

3 Undergraduate Credits*... $1697.88 (RESIDENT)

$2815.80 (NON-RESIDENT)

3 Graduate Credits*........... $1422.90 (RESIDENT)

$2561.70 (NON-RESIDENT)

*Graduate students must get permission from resident faculty to take the course

**Workshops taken for credit will have an additonal special course fee of $25 Per Credit Hour

Non-Credit Workshops....... $1100.00 ($75 course fee is included)

PLEASE INDICATE YOUR PROGRAM CHOICE BELOW. (please choose one)

2023 offerings : Offering Printmaking, Ceramics, Painting, Glass and Textiles

PRINTMEDIA WORKSHOP

Graduate

Undergraduate

Non-Credit

CERAMICS WORKSHOP

Graduate

Undergraduate

Non-Credit

PAINTING WORKSHOP

Graduate

Undergraduate

Non-Credit

GLASS WORKSHOP

Graduate

Undergraduate

Non-Credit

TEXTILES WORKSHOP

Undergraduate

Graduate

Non-Credit

Housing Options - NOT AVAILABLE FOR 2023 *

-

PLEASE INDICATE BELOW IF YOU WILL NEED PARKING TAG. *

no parking pass needed

Parking +$20.00

**Refund Policy: Must have 7 days notice prior to the start of the program of withdrawal intention in order to receive full refund. No exceptions**

NOTICE OF YOUR ACCEPTANCE TO THE BLOSSOM ARTS PROGRAM WILL BE SENT BY EMAIL.

IF YOU ARE TAKING THE NON-CREDIT OPTION YOU WILL BE NOTIFIED OF THE TOTAL AMOUNT DUE AND PAYMENT OPTIONS AT THAT TIME.