Entry Form

A.R.T.S., INC. “50^th” ANNIVERSARY GALA

Outstanding Arts-In-Education Educator Awards

This form must be filled out in its entirety and accompany all applications due on or before Friday, December 16, 2011.

1. Official Entry Form
2. Name(required)
3. Home Address(required)
4. City(required)
5. State(required)
6. Zip Code(required)
7. Phone Number(required)
8. Disctrict(required)
9. School Name(required)
10. School Address(required)
11. City(required)
12. State(required)
13. Zip Code(required)
14. Phone Number(required)
15. Grades(required)
16. Arts Area (Please check all that apply to nominated educators’ program)
17. Dance
18. Music
19. Theater
20. Visual Arts
21. Summary and/or overview of nominees implementation of the arts in the education of children
22. New Field