Individual Artist Survey

Information correct as of this date:  

This information may be published:
Yes, please!   No, it is for Cultural Arts Council internal file only.

Resource is based in:
Douglas County   Paulding County

Name, Last:   First:  

Address 1:    Address 2:  
City:  State:   ZIP:  

E-mail:  

Phone (home):    (work):  
Would you prefer to be contacted      during the day?   or    during the evening?

Check the one which best describes you:

  Art Student (college level or above)
  Professional Artist (I have extensive training in my field, and earn all or part of my living
       as a teaching, performing, or exhibiting artist.)
  Avocational Artist (I have some formal training in my art form.)
  Self-taught (I have not received formal training in my art form.)

Arts Field:
   Music    Visual Art    Theater    Dance    Literature
   Specialty:   

Please indicate the arts services you can offer your community:

   Children’s classes & activities    Adult classes & workshops
   Readings/lectures
   Exhibitions of my work
   Performances (solo) for audiences that are:
          large      small      young      all ages

   I offer special programs:  

Please indicate your fee/price range:
 Free     up to $100     up to $250     up to $500     Other: 

Please complete this form on your computer and print out the page.
Feel free to enclose your resume or brochure for our resource file. We would like to get to know you better, and will keep you in mind for various opportunities to showcase your talent.

Mail to:
Cultural Arts Council
Attn: Douglas/Paulding Arts Resource Survey
P.O. Box 2018
Douglasville, GA 30133

Questions? Contact Cary Cleaver (daytime): 770-949-5351