Artist Information Survey

Accessible Arts is occasionally asked to communicate information to artists with disabilities. In addition, our own programming sometimes offers opportunities for artists with disabilities. We have an extensive list of artists with whom we collaborate, but know of few artists with disabilities (adult or children). If you have artistic abilities (whether you do or do not have a disability), we would like to know your name and information. Please complete and return this form to:

Accessible Arts, Inc.
1100 State Avenue
Kansas City, KS 66102

If you would like to have this information in Braille or by e-mail, please let us know at:

913/281-1133 accarts@accessiblearts.org

Artist's name: Survey Date:
Address: City/St/Zip County

Phone: Day

Evening

Fax

E-mail address:

Area(s) of artistic expertise:

Would you be interested in teaching in a school or community setting? o Yes o No

Artistic training:

Age range: o 15-18 o 19-25 o 25-60 o 60-75 o 75+

Please mark the area of your talent:
Crafts
o general
o clay
o needlework/fiber
o glass
o leather
o metal
o mixed media
o paper
o plastic
o wood
Dance
o general
o ballet
o choreography
o ethnic
o improvisation
o jazz or tap
o modern
Visual Arts
o general
o drawing
o experimental
o painting
o photography
o printmaking
o sculpture
Design Arts
o general
o architecture
o environmental
o fashion
o graphic
o illustration
o industrial
o interior
o landscape architecture
o urban/metropolitan

 


Settings in which I have worked with persons with disabilities include (below):

Dramatic Arts / Theatre
o general skills
o acting
o directing
o mime
o performance
o playwriting
o production
o public speaking
o puppetry
o for general audiences
o for young audiences
Learning Strategies
o general
o 6-trait writing
o integrated assessment
o critical thinking
o learning styles
o multiple intelligences
o questioning
Literature
o general
o journal writing
o playwriting
o writing fiction
o writing non-fiction

o writing poetry

Media Arts

o general

o audio

o computer graphics
o film
o radio production
o tv production
o video

o Interdisciplinary Arts
(pertaining to a single work created by integrating more than one arts discipline)

Music

o general

o band

Music, continued

o chamber

o choral

o ethnic

o jazz

o new

o orchestral

o popular

o solo / recital ________________

o songwriting / composing

Opera/Music Theatre

o general

o performance

o production

Folk Arts

o general

o dance

o decorative

o family lore

o instrument making

o music

o needlework/fiber

o storytelling

Arts Ed for Persons with Disabilities
o attention deficit disorder
o atypical mobility
o autism
o behavior disorders
o cerebral palsy
o deaf/hard of hearing
o developmentally delayed
o learning disability
o mental/psychological disability
o physical disability
o speech and language delay
o traumatic head injury
o visually impaired/blind

o _____________________

_______________________

(other disability)
o Inclusive classrooms (persons with disabilities mainstreamed with non-disabled persons)
o self-contained classrooms (only persons with disabilities)
o "pull-out" groups (persons with disabilities pulled from mainstreamed classrooms for special sessions)
o family member with disability (please specify) ________________________________
o friend with disability (please specify) _______________________________________
o other settings (please specify) ___________________________________________

Optional Information

I am an artist with the following disability(ies) ___________________________________________

Ethnicity: o African American o Native American o Asian Hispanic/Latino o Multi-Racial

o Caucasian o Other ____________________________

Sex: o M o F Birth date _______________

If you are an artist who is at least age 18 and have a disability, we encourage you to also register on the VSA Artist Registry: http://www.vsarts.org/x714.xml