JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Artist Workplan
Please complete Work plan two weeks prior to starting residency.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
1.Artist First Name
*
Your answer
2.Artist Last Name
*
Your answer
1.Artist First Name
*
Your answer
2.Artist Last Name
*
Your answer
3.Artist Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
4.Artist Phone Number
Your answer
5.Organization Name (if N/A write N/A)
*
Your answer
6.School Name
*
Your answer
7.School Address
*
Your answer
8.Work Focus
*
Literary (writing, poetry, bookmaking, etc)
Visual (painting, sculpting, fiber, etc)
Multimedia (film, video, photography, etc)
Multidisciplinary (one or more of the above)
Other:
9.If you selected "Performing," what area of the performing arts was covered?
*
Music
Dance
Theater
N/A
10.Please select your highest level of Education
*
High School Diploma/GED
Associate Degree
Bachelor's Degree
Master's Degree
PhD
Other:
11.Please list years of experience working as an Artist Educator in a classroom setting
*
0-1
1-2
3-5
6-8
9+
12.Identity Based Questions
*
Your answer
13.Please Identify Your Gender. (You may you choose to opt out)
*
Your answer
14. Please provide a short bio of yourself including your experience as an artist-educator. This will be used by Arts @ Large to highlight the Artist Educator completing contracted services residencies.
*
Your answer
15.Will you be contracting with Arts @ Large as an Individual or as an arts organization
*
Individual
Organization
Required
16.Is this your first project with Arts @ Large?
*
Yes
No
17.Dates and times of Service. Example: September 4,5,6; 10:00am-12:00pm
*
Your answer
18.Please list grade levels and number of students to be served. Example: 7th Grade: 35 students 8th Grade 25 students
*
Your answer
19.Proposed Budget
*
Your answer
20.Learning Targets: Complete the Following on a separate word documents and email to
jacque@artsatlargeinc.org
and
elodie@artsatlargeinc.org
21.What Steps will you take to ensure that this work allows success for students of all learning and Physical abilities
*
Your answer
22.What resources do you need to make learning more successful (from either Arts @ Large or the school you will be serving)
*
Your answer
23.Are there any opportunities throughout the residency where we can celebrate or showcase student created work?
*
Your answer
24.Individuals providing service, please call in your full name, date of birth, and social security number, to Arts @ Large at 414-507-2251. We update background checks annually
*
Your answer
25.Final Checklist
Background Check called into Caren Cazares 414-507-2251
W-9 Submitted to Caren Cazares (
caren@artsatlargeinc.org
)
Certificate of Insurance has been submitted, naming Arts @ Large as an additional insured, to Arts @ Large, 1100 South 5th Street, Milwaukee, WI 53204.
Artist does not have professional liability insurance (if you didn't check the box above). Arts @ Large will provide insurance during contracted dates & times.
Submitted Weekly Learning Targets via Email to Jacque Troy (
jacque@artsatlargeinc.org
) and Elodie Ontala (
elodie@artsatlargeinc.org
).
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Arts @ Large.
Report Abuse
Forms
