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:

Address:

City:

Zip:

County:

Phone Day:

Phone 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
general
clay
needlework/fiber
glass
leather
metal
mixed media
paper
plastic
wood

Dance
general
ballet
choreography
ethnic
improvisation
jazz or tap
modern

Visual Arts
general
drawing
experimental
painting
photography
printmaking
sculpture

Design Arts
general
architecture
environmental
fashion
graphic
illustration
industrial
interior
landscape architecture
urban/metropolitan

Dramatic Arts / Theatre
general skills
acting
directing
mime
performance
playwriting
production
public speaking
puppetry
for general audiences
for young audiences

Learning Strategies
general
6-trait writing
integrated assessment
critical thinking
learning styles
multiple inteligences
questioning

Literature
general
journal writing
playwriting
writing fiction
writing non-fiction
writing poetry

Media Arts
general
audio
computer graphics
film
radio production
tv production
video

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

Music
general
band
chamber
choral
ethnic
jazz
new
orchestral
popular solo / recital
songwriting / composing

Opera/Music Theatre
general
performance
production

Folk Arts
general
dance
decorative
family lore
instrument making
music
needlework/fiber
storytelling

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

Settings in which I have worked with persons with disabilities include (below):
inclusive classrooms (persons with disabilities mainstreamed with non-disabled prsons)
self-contained classrooms (only persons with disabilities)
'pull-out' groups (persons with disabilities pulled from mainstreamed classrooms for special sessions)
family member with disability (please specify) _______________________________________
a friend with disability (please specify) _____________________________________________
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 _______________