Cultural Arts Assembly Expression of Interest

Cultural Arts Assembly Expression of Interest

Complete one form for each assembly.
Site Name*
Site Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Email cc:
If you would like us to copy someone on email correspondence, please provide their email address.
Our plan is to have:*

One (1) 45-minute assembly per dateTwo (2) back-to-back assemblies per date, each 45 minutes with 15 minutes in between
Preferred Date*

MonthDayYear
Date
The best time for our assembly on the Preferred date:

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
The 2nd best time for our assembly on the Preferred date:

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Second Choice Date*

MonthDayYear
Date
The best time for our assembly on the 2nd Choice date:

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
The 2nd best time for our assembly on the 2nd Choice date:

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Audience: (check all that apply)

Pre-kKindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Other
Audience for Assembly 1: (check all that apply)

Pre-kKindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Other
Audience for Assembly 2: (check all that apply)

Pre-kKindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Other
Please add any other information regarding the date, time of day, or audience:
Preferred Artist: (select one)*

Linda Harris and David ColeMunit MesfinGerdanMagpieMark Jaster & Sabrina MandellMr. LiloArtists in Motion!Seán Heely Trio
2nd Choice Artist: (select one)*

Linda Harris and David ColeMunit MesfinGerdanMagpieMark Jaster & Sabrina MandellMr. LiloArtists in Motion!Seán Heely Trio
Please add any other information regarding the artist selection:
This form completed by:*

First NameLast Name
Do you have the authority to book assembly programs? (If you are completing this form for your Supervisor or other authority, please check No.)*

YesNo
Who has the authority to book assembly programs?

First NameLast Name
Title
For more information, reach out to:
- Metro DC Area Contact:
  Sarah Lanzo
  sarahlanzo@carpediemarts.org
- Eastern Shore Contact:
  Leslie Adelman carpediemarts.shoreprograms@gmail.com
If you have any questions or problems with the form, please email info@carpediemarts.org.
Should be Empty: