ECAC High School Portfolio Review will be held on Saturday, November 9, 2019 from 10:00 a.m. to 4:00 p.m. The Eccles Community Art Center is located at 2580 Jefferson Avenue in Ogden, Utah.

Name

First Name *

Last Name *

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Phone

High School You Attend

Grade

Junior
Senior

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Please list all the Utah schools you are interested in:

Entry Fee

$5 fee (includes entry in the January 2019 Scholarship Competition)

You may also register in person at 2580 Jefferson Avenue, Ogden, UT, or by phone at 801-392-6935.

Select a Payment Method

Credit Card
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Cardholder Name

Credit Card #

Visa MasterCard American Express Discover

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Security Code

Account Holder

First Name

Last Name

Account Type

Checking
Savings

Account Holder Type

Personal
Business

Account Number

Routing Number

I authorize Eccles Community Art Center to initiate, and my financial institution to honor, a one-time electronic debit from my bank account on the date, for the amount, and from the account listed.

Your total payment will be .

Your credit balance will cover

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