FESTIVAL DAY ARTIST PARTICIPATION FORM

Festival Day: Jungle Art -- Friday May 2, 2014

**Form must be returned to ACT by Monday, March 17!**
MAIL: ACT; 1140 Monroe Ave, Ste 4101; Grand Rapids, MI 49503

PHONE: 616-885-5866

FAX: 616-885-5867

Name ___________________________________________ Phone (Home/Cell) ___________________________________

Address _________________________________________ Phone (Work) _______________________________________
________________________________________________ E-mail: _____________________________________________
Please describe the art discipline(s) and media that apply to your area of expertise (Painting, Vocal Music, Creative Movement,
etc.). If you have a specific idea for a workshop activity, please outline it here:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
The Festival Workshops run from 10:05 am to 1:20 pm. How many sessions (1 to 4, 40 min. each) would you prefer?
___________________________________________________________________________________________________
List any time restrictions you may have: __________________________________________________________________
Maximum number of participants for your workshop activity? ________________________________________________
List any disability group that would not be appropriate for your workshop activity, or with whom you would prefer not to
work: ______________________________________________________________________________________________
___________________________________________________________________________________________________
Describe physical facility needed for activity (amount of space, sink, etc): _______________________________________
___________________________________________________________________________________________________
List any equipment (projector, I-pod dock, etc.) you may need ACT to supply: ____________________________________
___________________________________________________________________________________________________
Workshop Supplies: We ask artists to pick up necessary materials for their workshop from the ACT offices before Festival Day.
Or, if necessary artists may purchase supplies up to $50/per workshop. You will be reimbursed for purchases upon submission
of receipts and check request form (which will be provided when we send you your workshop schedule).
We are able to pay a stipend of $60 per 40 min workshop. However, many artists very generously contribute their time or
reduce their fees for Festival Day, which is greatly appreciated and helps us to continue making ACTs Festival Day an amazing
day in our community. Please indicate your fee structure below:
Donating time: _____________ Workshop Fee: ______________
Is there an artist whom you would like to recommend to ACT? If so please list their contact info below (include address and
phone if possible):