Theatre Artist Intake Form
This information will be used so we can get to know you better. By asking detailed questions we hope to save everyone time by minimizing the need to repeat these questions in the future. Only administrative staff of Amphibian Stage will have access to this information. Your responses will be kept private and secure. The information will not be used for discriminatory purposes. You can change this information in the future by reaching out to us via info@amphibianstage.com
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I'm based:
*
In the DFW Metroplex
Outside of the DFW Metroplex
Where are you located?
I have reliable housing and transportation in DFW
*
Yes
No
I'm a/an (check all that apply)
*
Actor
Director
Playwright
Stage Manager
Assistant Stage Manager
Run Crew/PA/Technical Overhire
Scenic Designer
Costume Designer
Lighting Designer
Sound Designer
Projection Designer
Fight Choreographer
Intimacy Choreographer
Choreographer
Music Director
Voice/Dialect Coach
Other
Do you belong to a union?
*
AEA Member
AEA Equity Membership Candidate
SDC
USA
I do not belong to any unions
Other
I identify as (check all that apply)
Aboriginal Person (e.g., North American Indian, Metis, or Inuit)
African-American/Black (not of Hispanic origin)
Alaskan Native
Arab
Asian (Chinese, Japanese, Korean, Filipino)
Caribbean (West Indian)
Caucasian/White (not of Hispanic origin)
Hawaiian
Hispanic/Latin(a/o)/Latine
Multi-Ethnic
Pacific Islander
Samoan
South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)
Southeast Asian (e.g., Vietnamese, Cambodian, Malaysian, Laotian, etc.)
West Asian (e.g., Iranian, Afghan, etc.)
Prefer not to say
Other
Do you identify as transgender?
Yes
No
Prefer not to say
I identify as
Male
Female
Non-Binary
Agender
Genderfluid or Genderqueer
Prefer not to say
Other
My age is
0-18
18-30
30-45
45-60
60-75
75+
My pronouns are
Headshot
Browse Files
Drag and drop files here
Choose a file
Non-actors, we would still love a photo of you-it doesn't need to be a professional headshot.
Cancel
of
Resume
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Website, Online Portfolio, or Reel
I'd like to be considered as a teaching artist for daytime community outreach workshops (paid position).
*
Yes
No
In what areas of teaching are you proficient?
I'd like to receive emails about audition and employment opportunities.
*
Yes
No
Is there anything else you want us to know?
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