MAC Workshop or Program Proposal

WORKSHOP OR PROGRAM PROPOSAL

If you are interested in teaching a workshop, program, or class, please fill out this form in its entirety. Proposals will be selected based on relation to MAC's mission, time schedule, value and feasibility.
Proposed Program or Workshop Title*
creative title or simple subject area (area of expertise)
Instructor Name*

PrefixFirst NameLast NameSuffix
Business Name:*
or your full name for your W-9
Phone*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Email*

Confirmation Emailconfirm email example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Physical Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Where did you learn about the opportunity to teach a class or workshop, lecture, or do a presentation for the Molokai Arts Center?*
Please explain "Other" or tell us who referred you.
What is your program/workshop timeline?*

This is an ongoing, regularly scheduled class (i. e. weekly, monthly)This is a one-time workshop (may be divided into 2 or more sessions)This is a one-time lecture or presentation (not a class or workshop)This is for listing on the Molokai Artist DirectoryI am available to fill in as a Substitute ArtistsOther
Please explain "Other"
Proposed date(s)/time for workshop OR best day(s) of week/time:*
Proposed Start Date (Please give us at least 3 weeks for planning & promotion):*

MonthDayYear
Date
Proposed Alternate Start Date*

MonthDayYear
Date
Participant Age Level (check all that apply)*

Keiki Age 5-8 or Grades K-3Keiki Age 9-1 1 or Grades 4-6Youth Age 12-13 or Grades 7-8Youth Age 14-18 or Grades 9-12AdultsSeniors/KupunaAll Ages Welcome
Participant Age Level additional comments
Participant Art Level*
Minimum number of participants:*
Maximum number of participants:*
Check one of the following:*

I would like to volunteer my time for this program.I will charge MAC a fee for this program*
How much will you charge the MAC?*
Put $0 if you are volunteering.
If you will be charging MAC for the program, how would you like to be paid*?

Flat fee.Fee based on attendance.
*Please note that MAC will need to be sent an invoice after completion of program before payment can be made.
Media(check all that apply):*

CeramicsDanceDrawingFloralGlassHawaiian Plants, ResourcesJewelryLanguage, Poetry, ProseLeatherMetal worksMusicPaintingPaper/Mixed MediaPhotographyPotterySculptureTextileTheatreToysWeaving (fabric/other)Wood - decorativeWood – furnishingsOther
Other Media:
Technique:*
Suggested cost of program for participants on Molokai:*
What would be a fair value to charge a person for your class? If accepted, we do not want to under-charge (de-value) or overcharge.
Please provide a brief bio. This will be used for promotional material should you be selected.*

0/250
Please give an additional description of your work, including information about the process used to create your artwork, and experience teaching this art.
Artwork Description:*
Are there special location or facility needs for your program?*

NoYes
If Yes, what are the special location or facility needs?*
If No, type "N/A"
Are there special equipment needs for your program (i. e. tables, chairs, projector, tools, etc.)?*

NoYes
If Yes, what are the special equipment needs?*
If No, type "N/A"

Please list all supplies, tools and materials needed for the program. Please also provide information on where materials can be purchased. Itemize costs if provided by Molokai Arts Center. Factor in time and shipping cost to bring the items to Molokai. ** Be thorough. If none, write "N/A" in first box.*

	Description of Item	Qty	$Cost	Suggested Supplier	Instructor to Provide	MAC to Provide
1
2
3
4
5
6
7
8

**Be aware that our geographic isolation makes acquisition of supplies both costly and time consuming. Many items considered standard elsewhere must be special ordered on Molokai and require time for shipping. Do not assume supplies can
be readily acquired on island. We need a minimum lead time of three weeks, preferably more, to order any materials. If a program must be cancelled due to lack of supplies resulting from the instructor’s failure to adequately plan for and inform the MAC of materials cost or procurement, the MAC will not be responsible for paying instructor fees or travel costs.
I have read and understood the above statement regarding supplies.**
Are students required to bring anything to class (include safety/dress requirements)?*
Type "NO" if none.
Do you have any other needs for the program not covered by the form above? Please outline in detail.*
Type "NO" if none.
Please attach any relevant photos or documentation of your work, or links to websites which show your work.
Website*
If none, type "NONE"
Social Media
Work Sample #1:*

Cancelof
Work Sample #2:*

Cancelof
Work Sample #3:

Cancelof
One last thing. Are you able to donate art work (by you) to our next Soup R Bowl fundraiser in March?*

YesNoOther
Other
Should be Empty:

WORKSHOP OR PROGRAM PROPOSAL