Intake form

Help us serve you better

Name *

Email address *

What is your age?

What artistic programs are you interested in?

Please select at least one option.

Performance Theatre

Drawing and Painting

Dance

Culinary Arts

Music Creation

What is your current educational status?

What challenges do you face that you hope to address through our programs?

How did you hear about artistry for change?

Please select at least one option.

Social Media

Friend or Family

School

Community Event

What are your personal goals related to art?

Do you have any previous experience in the arts?

If yes, please describe your previous experience.

Additional questions or comments

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Artistry For Change