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MAA App 10-11 Lighter Logo

MAA App 10-11 Lighter Logo

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Published by Matt Bradley

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Published by: Matt Bradley on Oct 25, 2010
Copyright:Attribution Non-commercial

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10/25/2010

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MESTIZO ARTS
 
&
 
ACTIVISM
 COLLECTIVE
 
Are you interested in activism and art?Are you available Mondays & Wednesdays from 3:00–5:30pm?(November 15
th
, 2010 - May, 2011)Do you live on the West Side of Salt Lake?If you answered yes to these questions -- please apply!!
*Application Due November 8
th
, 2010*
 
PERSONAL INFORMATION:Name: _____________________________ School: ____________________________ Address: ________________________________________________________________ Home Phone: _______________________ Cell Phone: ________________________ Email: __________________________________________________________________ MySpace URL/Facebook (optional): _________________________________________ Gender: Female: ___ Male: ___ Ethnic Origin (optional—select below): ___ African American/Black ___ Asian American/Pacific Islander ___ Latina(o)/Hispanic ___ Native American/American Indian ___ Caucasian/White ___ Multiracial/Biracial ___ Other:_______________ Current Grade: ____ 9
th
____ 10
th
____ 11
th
____ 12
th
 EMERGENCY CONTACT:Name: _____________________________ Relationship: ______________________ Daytime Phone: _____________________ Work/Cell Phone: __________________ 
 
 
**Please answer the following questions within the space provided**
Applicant Signature: ___________________________ Date: ________________ 
**Note: Parental permission will be necessary in order to participate in this program.
1.
 
What are your other extracurricular commitments & community projects that you areinvolved in?2.
 
What does activism mean to you?3.
 
What is your experience with the arts?4.
 
What do you think are the most important issues for young people today?Please include the name and telephone number for one personal reference (teacher/family friend etc.) who we may contact:Name: ______________________________ Telephone Number: _____________________ The Mestizo Arts & Activism Collective is an equal opportunity internship provider.Do you have any special needs or physical limitations that need accommodation?

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