Mestizo Arts & Activism Application
Are you interested in ARTS & ACTIVISM? Want to get involved in Social Justice issues?  Earn College credit?

Apply now and tell a friend!  Please submit your application by September 28th.

Wednesdays | 3:30 pm – 6:00 pm
January 25th, 2023 - May 2023
Mary W. Jackson Elementary | 750 West 200 North | SLC, UT 84116

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Applicant Information
Name
 *
School
 *
Address
Cell Phone
 *
Home Phone
Email

 *
Gender
Ethnicity
 Current Grade
Clear selection
Guardian Information
Parent/Guardian Name
Home Phone
Relationship to Student
Cell Phone
Parent/Guardian Email
Have you received Covid-19 vaccination?
Clear selection
Do you have any food allergies? If yes please list
What extracurricular activities & community projects are you involved in?
Please write 100-300 words
Are you usually available to meet at Jackson Elementary on Wednesday from 3:30 - 6:00pm
What is your experience with the arts?
Examples include (but are not limited to): writing, dancing, painting, drawing, digital media, singing. Please write 100-300 words
What do you think is/ are the most important issue(s) for young people today?
Please write 100-300 words
The Mestizo Arts & Activism Collective is an equal opportunity community organization. Do you have any needs or physical restrictions that may need accommodation?
*Dietary restrictions included
How did you hear about MAA?
In addition, we also ask that you submit a piece of art or media that answers the question, WHAT DOES ACTIVISM MEAN TO YOU? *
This does NOT have to be something you have created or is original, but can be by another artist that you like.  Some examples include (but are not limited to): photograph, spoken word piece, poem, song lyrics, music video, story, painting, graffiti art, pencil sketch, or drawing, etc
Required
Questions?
Please email us at mestizo.artivism@gmail.com if you have questions about any part of the application or program.

Thank you!
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