Valley Arts Mentors: Mentee Registration Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
This program is for people who are 18 years old and up. Are you:
18 - 25
25 - 35
35 - 45
45 - 55
55+
Not 18 yet :)
What is your native language?
English
Spanish
Portuguese
Other
Can you tell us a little about your artistic practice? For example, which art form(s) you are interested in and why you enjoy it/them?
Is there anything in particular you would be looking for in a mentor? For example, is your primary interest in getting a feel for what it's like to have a career in the arts or just advice about training/your work, someone to bounce ideas off of, etc.?
How did you hear about Valley Arts Mentors?
Friend
Website
Blog/Newspaper/Social Media
Family
Other
What's the best way to get in touch with you?
phone
email
either one
Would you like to be added to the VAM mailing list?
Yes
No
Submit
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