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General Contact Information

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*Name of organization:
*Organization's phone
   (with area code):
Fax (with area code):
Organization's website address:
*Organization's street address:
 
*City:
*State (2-digit code)   ZIP: 
Please state exactly how you want your organization's name to be listed:
*Person completing the form:
*Title:
Email address:
*Phone (with area code):

Program Information

Please complete all question that apply and provide your best estimate for figures and dollar amounts.
1. What year did your organization begin?
2. What year did your organization begin offering arts education programs?
3. If applicable, provide your mission statement.
4. Please enter the ESTIMATED number of participants per year and the ESTIMATED annual revenue for programming in the following arts disciplines. GCAC will keep all participant and financial information confidential.

Then check the box next to any of the specific categories for which you offer education programming.
 
 

 Participants  
Per Year

 Annual
Revenue
Architecture

 $
Crafts
  Fiber Arts (weaving, beading, quilting, baskets, paper making)
  Jewelry
  Pottry/Ceramics
  Glass (stained glass, glass blowing)
  Flower Arranging
  Wood Carving
  Other

 $
Dance/Movement
  Tap
  Modern
  Jazz
  Ballet
  Ballroom
  Swing
  Salsa/ Latin
  Ethnic/Traditional
  Dance/Movement Therapy
  Other

 $
Ethnic or culturally specific (i.e. traditions, folk)

 $
Language Arts
  Poetry (writing, performance)
  Fiction/Creative Writing
  Book Clubs/Discussion Groups
  Public Reading
  Other

 $
Media Arts
  Film/Video
  Radio/TV Production
  Other

 $
Music
  Piano (instrumental)
  Guitar (instrumental)
  Other (instrumental)
  Choir (vocal)
  Solo (vocal)
  Music Appreciation/Music History
  Music Therapy
  Other

 $
Theatre/Drama
  Puppetry
  Storytelling
  Drama Therapy
  Theater
  Other

 $
Visual Arts
  Graphic Arts (drawing, printmaking, design)
  Mixed Media
  Photography
  Sculpture (stone, clay, bronze, wire, wood)
  Painting (oils/acrylic)
  Painting (watercolor)
  Art Appreciation
  Art Therapy
  Art History
  Other

 $
Other:

$
5. Indicate the types of arts education programs you provide. (Check all that apply.)
  Group classes/workshops
Individual instruction
Lectures or forums
Other: 		Camps
Conferences
Trips
6. When are your arts education programs offered? (Check all that apply.)
  Year-round
  Seasonal Only (check options below to specify.)
    Winter  Spring  Summer  Fall
  Weekdays (check options below to specify.)
    Mornings/Daytime  After School  Evenings
  Weekends (check options below to specify.)
    During festivals  During celebrations
7. Enter the ESTIMATED number of participants for each age group you serve. (Fill in all that apply.)
  All ages

Children (under age 5)

Children (ages 5-12)

 Teenagers (ages 13-17)

Adults

Seniors (65 and older)
8. Enter the ESTIMATED number of participants per year for each of the special populations you serve. (Fill in all that apply.)
  Physically challenged
  Psychologically challenged
  Economically disadvantaged
  At-risk youth  
  Other:
9. In what languages are your arts education programs offered? (Check all that apply.)
  English
Spanish
Somali
Sign Language
French
German
Russian
 Ukranian
Hebrew
Tibetan
Italian
Japanese
Yiddish
Other:
10. Please enter the ESTIMATED number of participants per year for each cost category and the ESTIMATED annual revenue earned for fee-based services. GCAC will keep all participant and financial information confidential.

If applicable, enter the amount your organization offers in scholarships each year.
 
Cost Category

 Participants  
Per Year

 Amount
Free
Fee charged

 $ (annual revenue)
Scholarships available

 $ (total amount given)
11. Indicate the level of experience people need to participate in your arts education programs. (Check all that apply.)
  No experience necessary
Some experience suggested		 Experience required
12. Enter the ESTIMATED number of people who either teach or lead your organization's arts disciplines. (Fill in all that apply.)
  Your staff

Artists/practitioners

Licensed educators

 Volunteers

Certified care professionals
13. How many arts education programs are or will be offered this year?
 
14. What is the typical class size?
 
15. Enter the ESTIMATED number of participants per year who receive credit for your arts education programs. (Fill in all that apply.)
  High school credit

College credit

Professional development credit

 HS community Service

Not applicable
16. Indicate where your arts education programs take place? (Check all that apply.)
  Arts facility
Private school
Place of worship
Senior center
Neighborhood storefront
Medical facility/clinic
Public school
College or university
Recreation/community center
 Library
Parks
Municipal building
Private home
Social service agency
Other business
Penal institution
Gallery
17. Do the sites where your arts education programs take place meet American Disabilities Act (ADA) requirements?
 
18. The sites where your arts education programs take place provide: (Check all that apply.)
  Free parking
Paid parking		 Access to public transportation
Childcare
19. Indicate how you promote your arts education programs. (Check all that apply.)
  Direct mailings
Paid advertisements
Brochures
The Web/Internet
Phone book (Yellow Pages)		 E-mail
Press releases
Word of mouth
Arts and community showcases
  Community directories
Firstlink		 Please describe:
  Through other organizations Please describe:
  Other:

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* I agree that the information provided on this form has been reported accurately and provides permission for such information to be processed solely for inclusion in the ARTS CLASSifieds online directory. GCAC will keep all participant and financial information confidential.