Student Application

Please fill out and submit the online application below.  If you want to submit a hard copy application please print, fill out and mail in the Student Application.

Online Student Application Form

  • Personal Information



  • Primary/Emergency Contact

    This person will be the contact in the instance of an illness or other issues that may arise during a class session. This person will also receive information about art center closings, upcoming events, art center news and classroom issues.


  • Social Worker or Case Manager



  • Medical Contact Infromation



  • Medical Information

    Please describe any special medical issues that Donna Lexa Community Art Centers, Inc. staff will need to know to most effectively work with the applicant. For each box checked, please explain.
  • PLEASE NOTE: We do not have the capacity to provide assisted toileting. Our facilities are handicapped accessible but our staff is restricted to art instruction. They are not equipped to provide personal care. Please plan accordingly.




  • Transportation

    STUDENTS NEED TO PROVIDE THEIR OWN TRANSPORTATION TO AND FROM CLASSES It is important for transportation to deliver and pick up as close to class time as possible. It is the student’s (or representatives) responsibility to coordinate transportation. Donna Lexa staff is not available prior to class time nor are they available to wait for late pick up after class. Please identify the type of transportation that will likely be used.
  • Please provide the name of transport and a telephone number.



  • STUDENT PARTICIPATION AGREEMENT:

    Billing is prepared monthly and is payable upon receipt. Questions regarding billing should be directed to the Business Office at 262-521-2292. To determine eligibility for financial assistance, please complete the financial assistance form and submit it along with your application. • A late fee may be charged for late payments • If a class is missed without prior notification, payment of class fee will be the responsibility of the student or financial representative • Two weeks advance notice of discontinuation or extended planned absences is required • Place in class will be reserved if requested due to temporary incapacity of student As a student and/or financial/student representative you are expected to: • Notify class teacher or the DLCAC office of planned and/or other absences • Coordinate your own transportation to and from the Center location consistent with class times • Ensure, negotiate, or designate responsibility for fee payment in a timely and consistent manner • Assume responsibility for payment of framing and other individual purchases of materials for personal use • Communicate your ideas, suggestions, and concerns regarding the program or its operation to an appropriate DLCAC staff member to improve the quality or delivery of service to you or others • Cooperate in the completion and return of periodic student updates to keep our records current


  • Agreement Acceptance

    I understand these responsibilities, and I agree to comply with all expectations and billing procedures. My signature indicates that I have read this agreement and understand its contents.