Pablove Shutterbugs, the signature arts program of The Pablove Foundation, teaches children living with cancer to develop their creative voice through the art of photography. Learning photography concepts alongside other kids undergoing similar experiences empowers our students to express themselves, exercise their independence, and practice new ways of seeing the world – all while having fun! Classes are provided for pediatric cancer patients ages 6-18 years old. There is no cost for children to participate in this program. All supplies and equipment are provided by The Pablove Foundation at no charge.

Shutterbug Student Application

Please complete all of the information on this application. Any missing information may delay your participation in the program. 
Para completar esta solicitud en español, haga clic aquí.
Student Information



"mm/dd/yyyy" ex: 11/22/1991









(Only if student is over 18 and prefers direct contact)





Parent/Guardian Information














(ex: Mom / Cell)
Emergency Contact Information
We will always contact the parents first in case of emergency. However, please provide contact information for someone else in case we cannot get ahold of the parents. For example: aunt, cousin, brother, friend, etc.



ex. "aunt" or "family friend"
Confidential Student Information
The Pablove Shutterbugs program is made possible through generous donations and grants from public and private organizations. Please complete the following information, which helps our prospective donors evaluate our programs. This information is for demographic purposes only, and will remain confidential. The Pablove Foundation will never use your name in association with your responses or to determine program eligibility.

                                          

(check all that apply)