EmailMeForm
HATTILOO'S BLACK THEATRE MANAGERS FELLOWSHIP
2021-2023 Cohort
made possible by The Black Seed Initiative
DATE
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NAME
First
Last
EMAIL ADDRESS
CELL PHONE
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PERSONAL MAILING ADDRESS
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
ABOUT YOUR THEATRE
NAME OF THEATRE
YEAR FOUNDED
MAILING ADDRESS
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
DO YOU IDENTIFY AS A BLACK THEATRE?
Yes
No
ORGANIZATION'S MISSION STATEMENT
ORGANIZATION'S VISION STATEMENT
WEB ADDRESS
CURRENT ANNUAL BUDGET
PROGRAMMING (check all that apply)
Produce Plays
Youth Programs
Community Programs
Programs for Theatre Artists
Other
DESCRIBE "OTHER" ACTIVITIES
NUMBER OF SHOWS STAGED IN A 12 MONTH PERIOD
One
Two
Three
Four
Four +
CLOSING DATE OF LAST SHOW
MM
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TITLES AND AUTHORS OF LAST THREE PRODUCED SHOWS
DESCRIBE ANY EDUCATIONAL PROGRAMS (leave blank if there are no educational programs)
DESCRIBE COMMUNITY PROGRAMS (leave blank if there are no community programs)
PHYSICAL AMENITIES (where do you produce your plays/programming?)
Own
Lease
City/government owned space
Shared space
Rent space(s) as needed
Operate in various spaces
ABOUT YOU
RACIAL IDENTITY
Black/African-American
Latinx
American or Alaskan Native
Pacific-Islander
Asian
White
My racial identity isn't listed
I'd rather not say
AGE RANGE
18-25
26 -35
36-45
46-55
56-65
66-75
76+
PROUNOUNS
She/her/hers
He/him/his
They/them/theirs
I'd rather not say
DESCRIBE YOUR EDUCATIONAL BACKGROUND
CURRENT POSITION WITH THE THEATRE
HOW LONG HAVE YOU HELD THIS POSITION?
Less than a year
One year
Two years
Three years
Four years +
DOES THIS POSITION SERVE AS YOUR PRIMARY SOURCE OF INCOME?
Yes
No
LIST YOUR PROFESSIONAL DUTIES
LIST YOUR THREE MOST RECENT PROFESSIONAL POSITIONS PRIOR TO YOUR CURRENT POSITION
PROFESSIONAL STRENGTHS (select all that apply)
Fundraising (individuals)
Fundraising (corporate)
Fundraising (foundation)
Grant Writing
Financial Management
Audience Development
Human Resources
Strategic Planning
OTHER STRENGTHS
PROFESSIONAL WEAKNESSES (select all that apply)
Fundraising
Grant writing
Financial Management
Audience Development
Human Resources
Strategic Planning
OTHER WEAKNESSES
ORGANIZATIONAL STRUCTURE
IS YOUR ORGANIZATION A 501(c)3 NON-PROFIT?
Yes
No
Pending
IF YOUR 501(c)3 IS PENDING, WHEN DID YOU SUBMIT YOUR PAPERWORK?
MM
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DD
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YYYY
IF "NO," DO YOU HAVE A FISCAL AGENT?
Yes
No
IF "YES," WHAT IS THE NAME OF YOUR FISCAL AGENT?
NUMBER OF FULL-TIME STAFF MEMBERS (include self)
One
Two
Three
More than three
NUMBER OF PART-TIME STAFF MEMBERS (include self)
One
Two
Three
More than three
NUMBER OF BLACK EMPLOYEES
WHAT ARE YOUR THEATRE'S TOP THREE STRATEGIC PRIORITIES THIS YEAR (2021) AND NEXT (2022)
YOU AND THIS FELLOWSHIP
LIST THE ORGANIZATIONAL CHALLENGES YOU WOULD LIKE TO FOCUS ON DURING THIS THREE YEAR FELLOWSHIP
HOW WOULD THE FELLOWSHIP SERVE AS A CRITICAL RESOURCE FOR YOU AT THIS STAGE IN YOUR CAREER?
TELL US ABOUT WHAT MAKES YOUR THEATRE SPECIAL. HOW IS YOUR ORGANIZATION'S WORK UNIQUE AND IMPORTANT? WHAT IS THE IMPACT OF THE WORK YOU AND YOUR ORGANIZATION DO IN YOUR COMMUNITY?
HOW WOULD YOU USE YOUR FELLOWSHIP EXPERIENCE TO BENEFIT YOUR THEATRE?
DESCRIBE ONE MANAGEMENT RISK YOU TOOK LAST YEAR. WHAT WAS THE RESULT?
IS THERE ANYTHING ELSE WE SHOULD KNOW ABOUT YOU?
ARE YOU ABLE TO PARTICIPATE IN EACH 3-WEEK SUMMER SESSION FOR YEARS 2021, 2022, and 2023?
Yes
No
I don't know
NAME OF REFERENCE 1
First
Last
RELATIONSHIP TO REFERENCE 1
EMAIL ADDRESS OF REFERENCE 1
CELL PHONE OF REFERENCE 1
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NAME OF REFERENCE 2
First
Last
RELATIONSHIP TO REFERENCE 2
EMAIL ADDRESS OF REFERENCE 2
CELL PHONE OF REFERENCE 2
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