| ARTIST INFORMATION |
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| Please complete the following information. Required fields are denoted in bold. |
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First Name |
MI |
| Last Name |
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| Address |
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| City |
State Zip |
| Day Phone |
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| Eve. Phone |
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TTY (if applicable) |
| Cell Phone |
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| Fax |
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Email
[This will be your USERNAME] |
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| In order to post your
art images in our online gallery, we require that you provide a
valid email address (above) and password. |
| Password |
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| Web Site |
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| Date of Birth |
Year |
| Gender |
Male
Female |
SS#
[Stored Encrypted]
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This option only applies to artists expecting to receive payment
from sales and/or services. |
| GROUP INFORMATION |
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| Group Name |
(example: ABC Orchestra, WWW Dancers, All People Players,
etc.) |
| Primary
Contact |
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| Contact
Title |
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| Address |
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| City |
State Zip |
| Day Phone |
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| Eve. Phone |
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| Fax |
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| Email |
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| Agency Name |
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| Agency
Contact |
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| Agency Phone |
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| Agency Email |
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Who should be the first contact for
performance/exhibit opportunities? |
| CATEGORIES* |
Check the category that applies
(Check all that apply within your chosen categories)
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FOR PERFORMING ARTISTS
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Dance |
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Vocal Music |
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Stand-Up Comedy |
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Theater |
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Instrumental Music |
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Performance Art |
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Other
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| Dance
Genre |
Ballet |
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Jazz |
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Traditional/ Folk
Dance |
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Tap |
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Contemporary/
Modern |
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Wheelchair |
| Music
Genre |
Bluegrass |
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Classical |
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Contemporary |
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Country/Folk |
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Ethnic/Traditional |
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Funk |
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Latin |
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New Age |
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Jazz |
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Opera |
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Pop |
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Rap/Hip-Hop |
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R&B |
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Rock |
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Theatrical |
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World |
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Contemporary
Christian |
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Other
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| Theatre
Genre |
Actor/Actress |
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Children's Theater |
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Clown |
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Comedy |
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Drama |
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Ethnic |
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Improvisation |
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Musical Theater |
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Pantomime |
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Puppetry |
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Shakespeare |
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Storytelling
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FOR VISUAL ARTISTS
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List your primary discipline
(example: painting, sculpture, photography, jewelry-making)
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List your primary media
(example: oil, stone, fiber, mixed media, ink)
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Do you serve as or are you employed
in any of these art-related activities?
Full Time
Part Time
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| Arts Consultant |
Artists' Agent |
| Framer |
Art Critic/Writer |
| Arts
Handler/Shipper |
Curator/Installer |
| Restorer |
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FOR LITERARY ARTISTS
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List your primary literary art
form(s)
(Example: writer, editor, poet)
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Describe
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| ARTIST PERSONAL PROFILE |
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Be sure to fill in all required fields
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(A) - Artist Title |
(example: Sculptor, Jazz Saxophonist, Vocalist, etc.) |
| (B) - Union
Affiliations |
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| Aftra |
AGMA |
AGVA |
| Equity |
SAG |
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| Other |
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(C) - When did you start creating artwork or performing?
What motivated you to begin?
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(D) - Describe your techniques and how you incorporate
your media/discipline |
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(E) - How long have you been exhibiting or performing
professionally? |
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(F) - If you have formal art training in your discipline,
what school(s) did you attend? |
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(G) - Please list degrees held. Example: BA, BFA, MA,
MFA |
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(H) - Do you have teaching experience and/or have you
ever been an Artist-in-Residence? |
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YES
NO
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(The following information assists us in responding to specific
performance and training requests.)
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| Ethnicity |
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| African American |
African |
American Indian |
| Asian |
Caucasion |
Hispanic |
| Pacific Islander |
Other |
Please list any disabilities |
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What accomodations might you need? |
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How did you find out about the Artist Registry? |
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Would you like to be included in our closed chatroom for
Registered Artists? |
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YES
NO
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Would you like to have your web site (if Applicable) included
with your biographical information on our web site? |
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YES
NO
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Would you like to be included on the National VSA Arts Artists
Registry? |
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YES
NO
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What types of training provided by VSA arts would benefit you
the most? |
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Please provide us with your personal statement for public
view
(50 words or less) |
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Please provide us with a short biography for public view
(200 words max.) |
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| TEACHING/TRAINING EXPERIENCE (Optional) |
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VSA Arts of Florida is
developing a roster of artists interested in providing training
and other types of community engagement activities. If you are
interested in being contacted about providing these services
please fill out this section.
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| Are you interested in
being contacted? |
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YES
NO
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| In which of the
following do you have experience or interest? |
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| Artist- in-
Residence |
Workshop Leader |
| Keynote Speaker |
Lecture
Demonstration |
| Trainer |
Other |
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Briefly describe the programs, training or other activities you
do. |
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What age groups do you serve with your programs? |
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Where and for whom did you perform these services? |
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| Notice:
In order for you to be accepted as a member of the Artists
Registry, you must complete all required sections of the
application and submit a sample of your artwork to VSA arts of
Florida.
Please send a current resume, and a current photograph of
yourself (if available). Provide a sample of your work on
cassette tape, CD, videotape, slides, disk, photo or text and any
additional biographical information, news clips, promotional
materials and other related documents for your VSA arts file to
Jennifer Bade at the address below. Visual artists must also
send a descriptive sheet of the artwork. (Click here
for the form) You may choose the option of submitting a photo of
your work to the On-Line Gallery for approval once you have
completed this online registration form.
As a registered member of the Artists Registry, you will be
able to upload photos or text of your work to our Online Gallery
located on our web site or submit your work to Jennifer Bade
the address below for posting in the Gallery. Once you have
filled in all required fields and submit this registry form, you
will be forwarded to a web page with instructions for uploading
your images or text online.
Jennifer Bade
Grant Specialist
VSA Arts of Florida
3500 East Fletcher Ave. Suite 234
Tampa, Fl 33613
813-558-5093 Fax 813-975-6596
e-mail: Bade@coedu.usf.edu
IF YOU HAVE ANY QUESTIONS OR DIFFICULTIES WITH THIS FORM,
PLEASE CALL Jenn, Adult Program Coordinator.
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| Please read the
Statement of Understanding and Submission Guidelines before
submitting this form.
Click for
Statement of Understanding
Click
for Submission Guidelines
Have you read the Statement of Understanding and Submission
Guidelines?
YES
(By checking this box, you state that you have read and agree to
the Statement of Understanding and Submission Guidelines)
Would you like to be contacted by potential employers?
YES
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