NOTE: Please enter answers in the fields provided immediately below each question:

1) What is your age and place of birth?

           Age:     Birth Place:

2) What is your ethnic descent?

African Asian European Latin Middle Eastern Mixed Native American Pacific Islander 

 

 Other:    Specify:

3) What is your religious/spiritual background?

          Agnostic    Atheist    Baha'i   Buddhist   Christian   Confucian   Hindu   Indigenous [Tribal]

          Jewish   Muslim   Neo-Pagan   New Age   Scientology   Shinto   Sikh   Taoism

 Other:    Specify:

4)  Briefly describe yourself? (i.e.  childhood upbringing, education, people that you most admire, etc...)

5)  Have any particular artists or movements influenced your style?  (i.e. Impressionism, Modern, Postmodern, Public Art, Surrealism, etc...)

6)  Do you have a preferred genre?  (i.e. Abstract, Commercial, Ethnic, Fantasy, Gothic, Nudes, Portraits, Social Commentary, Visionary, etc...)

7)  Do you have a preferred medium?  (i.e. Computer, Graphics, Installations, Paints, Photography, Sculpture, Mixed Media, Textiles, etc...)

 8)  What type of artwork would you like to contribute: (i.e. Arts & Crafts, Musical Composition, Painting, Pottery, Sculpture, Woodwork, etc.)

9)  Enter any additional comments you'd like to make: