EmailMe Form - Art Without Boundaries App

Name *

First Last

Pronouns

Birthday *

MM / DD / YYYY

Current Grade *

Address *

Street Address City State / Province / Region Postal / Zip Code

Parent/Guaridan Phone Number *

### - ### - ####

Student Phone Number

### - ### - ####

Student E-mail Address

Parent/Guardian E-mail Address #1 *

Parent/ Guardian E-mail #2

Art with Boundaries

What location are you interested in? *

Art Without Boundaries schedule:
In-person Saturdays October 9th - May 21, 12:30-2:30PM.
Virtually December 4 & 11 10:00AM-12:00PM.
There are 23-24 total meetings, depending on location
There are breaks for holidays, school breaks, etc.

OPTIONAL: Please upload a list of your performance, writing, and or related artistic experience (or upload a resume)

Why are you interested in participating in this program? *

Please explain in detail.

What are two or three social issues, themes, or stories you would like to tell or explore in this program?

The next series of questions will assist the project mentors in learning more about your artistic skills and interests. Experience with instruments or writing and reading music is not required to participate in this production.

Please list any instruments you play and for how long you've played them.

Please indicate your experience in the following:

	5 - Most Experienced	4	3	2	1 - Least Experienced	N/A
Creative Writing
Writing Music
Reading Music
Teaching music to others
Improvisation with other actors
Dance/Movement
Art (Drawing/Painting)
Art (Digital)
Performing as an Actor or Dancer
Performing as a Musician or Singer

Is there anything else you would like us to know?

Thank you so much for your interest in the Art without Boundaries

If you have any questions, please email KIDSTAGE@villagetheatre.org