ArtReach Free Workshop Application

Date*

Name of School*

Address*

Street Address City State ZIP Code

Principal Name*

First Last

Email*

Phone*

Contact if other than Principal

First Last

Other contact phone

Other contact email

School Information

Grade levels in school*

Total number of students in school*

Visual Art Instruction Information

Do you currently have a visual art program at your school?*

Yes
No

What program?*

Are you a Title I school?*

Yes
No

Percent Title I eligible students*

Do have a PTA or PTO that funds arts programming for your school?*

Yes
No

Does your school or district have a Foundation that funds arts programming for your school?*

Yes
No

Brief Explanation of Need

Please describe why you believe your school qualifies for a free or low cost ArtReach program:*

ArtReach Program Logistics

Would you like ArtReach workshops for more than one grade level?*

Yes
No

The ArtReach Free Program provides up to four classrooms with ten workshops. Additional classrooms may be added at a discounted rate.

What grade levels will we work with?*

Total number of students in these grade levels?*

Does your school have a multi-purpose room that could be used for ArtReach workshops?*

Yes
No

ArtReach requests an empty classroom for workshops. Classes will rotate through the room. A sink is helpful, and allows us to include paint in your workshops.

When would you like the ArtReach program to take place? (check all that apply)*

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