First Name of Participant
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Last Name of Participant
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Participant Email
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Participant Phone
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Participant Date of Birth
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Month
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Day
Year
Parent/Guardian Name
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Parent/Guardian Email
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Parent/Guardian Phone
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Teacher Name
Teacher Email
Teacher Phone
Participant School
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Participant Grade
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Have you participated in Arts & Justice before?
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Yes
No
Please tell us about your experience in the arts (prior experience is not necessary.)
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What art forms do you participate in? (painting, dance, writing, acting, music, etc.)
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How long have you participated in those art forms?
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What do you hope to learn from participating in Arts & Justice?
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What theater, film, or visual artists create work you admire, and why?
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Is there a social justice issue you feel strongly about? If so, tell us about it.
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Tell us about a time you made a mistake. What did you learn from that experience?
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How did you hear about Arts & Justice?
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Please list your weekly availabilities (Monday-Friday) during the Spring semester. We need this information because we will schedule a brief interview with you before the start of the program. We also need to make sure that you are available for the program in its entirety.
I understand and accept these terms: I must commit to all workshops on Thursdays and some Fridays 4pm - 6pm from February 4, 2020-May 14, 2021.
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Yes
No
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