All Means All - Seeking Artists

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We are asking that you complete this form as part of the All Means All Artist Development program. The program goals are: 1.) Establish a network of organizations working in the arts with people with disabilities, 2.) Provide artists with disabilities working in the arts the opportunity to showcase their work; 3.)Provide an opportunity for participants to identify their artistic and professional development needs; 4.)Provide opportunities for professional/career development and 5.) Raise the visibility of artists with disabilities.

Email *

I would like to participate in the All Means All Artist Development Program. *

Yes

Maybe

What is your first and last name *

What is your phone number? *

What is your disability? If you do not have a disability, please type NONE. *

If you have a disability, please indicate the TYPE of disability you have: *

Sensory

Physical

Mental

Developmental

Learning

Other:

I give permission to All Means All to take my photo and have me in videos. It is ok to use, display, copy, edit publish, release, distribute, publicly perform these photographs, videotapes, audiotapes and sound recordings, and use my name in association there with, in any way and as often as desires, whether within All Means All workshops or public events, without payment of further compensation to me. I understand that All Means All there to owns these photographs, videotapes and audio/video tapes, and the negatives there of, and the sound recordings, and the copyright. *

I agree to this statement

I do not agree to this statement

What is your age? *

What is your race/ethnicity? Check all that apply. *

African-American/Black

Caucasian/White

American Indian

Hispanic/Latino

Asian

Prefer Not to Say

Other:

Required

Where were you born? *

In the United States

Outside the United States

What is your total, annual household income? *

$9,999 or less

$10,000 - $19,999

$20,000 - $29,999

$30,000 - $39,999

$40,000 - $49,999

$50,000 - $59,999

$60,000 or more

Prefer Not to Say

Do you participate with an organization that works in the arts with people with disabilities? *

Yes

Maybe

Have you ever had the opportunity to showcase your work? *

Yes

Maybe

If you have had an opportunity to showcase your work, how many times in the last year have you showcased your work publicly? If you have not had an opportunity to showcase your work before, please select NONE. *

What are your needs for artistic and professional development?

Please provide any comments or feedback that would make this experience most rewarding to you.

A copy of your responses will be emailed to the address you provided.

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