ArtReach Free Workshop Application Date* Name of School*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Principal Name* First Last Email* Phone*Contact if other than Principal First Last Other contact phoneOther contact email School InformationGrade levels in school*Total number of students in school*Visual Art Instruction InformationDo you currently have a visual art program at your school?*YesNoWhat program?*Are you a Title I school?*YesNoPercent Title I eligible students*Do have a PTA or PTO that funds arts programming for your school?*YesNoDoes your school or district have a Foundation that funds arts programming for your school?*YesNoBrief Explanation of NeedPlease briefly describe why you believe your school qualifies for a free or low cost ArtReach program:*ArtReach Program LogisticsWould you like an ArtReach workshop for the entire school?*YesNoWhat grades will we work with?*Total number of students?*Does your school have a multi-purpose room that could be used for ArtReach workshops?*YesNoWhen would you like the ArtReach program to take place? (check all that apply)* August September October November December January February March April May June July Year?*CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.