AWDA Artist Profile/Membership Form
(Please list info when possible! Thanks!)

This form is intended for use only by the Artists With Disabilities Alliance -- for communicating to and networking among members. There is no charge at this time for membership; all current activities are volunteered by members.

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Title:
Name:
E-Mail:
Address Line 1:
Address Line 2:
City:
Postal code:
Country:
Hard Line Phone:
Cell Phone:
What is your web site address/url:

Preferred means of contact about AWDA meetings/activities - indicate (check one)
e-mail:   mail:   phone:   fax:


_________________________________________


Choose one or more:
Category of work in the arts:

 

If other, more categories, or more detail, write in here: 


Write in your responses in the areas below. Provision of the following info is optional.

Artistic Abilities:



Other strengths, skills offered to AWDA:



Artistic Goals:



Wish List of needs to achieve Artistic Goals:



Disabilities (if you choose to disclose):



Accommodations (disability related) needed to participate in AWDA:


Other interests and activities enjoyed:

Please feel free to:


• complete the artists profile, so a profile page can be made for each member
• send your artwork to place on the site. JPEG or Gif files for images and Quick Time for video and sound. If you don't have digital files please send your tapes, video tape or images to:


OpusArts LLC.
1144 Ottawa Avenue
St. Paul, MN 55118


Please include a self-addressed, postage paid return envelope so your work can be returned. This is necessary to create an online portfolio for each member.

Thank you.

 

Is this communication urgent? Yes No

DATE OF THIS RESPONSE:  DAY:   MONTH:   YEAR:

 

Contact OpusArts LLC. at: 651 457 4376


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WARNING!
DO NOT submit usernames or passwords or other sensitive/financial information using the above form. Click here to report abuse if the above form asks for your username/password/financial information.