Artist Roster Application - Independent

Artist Roster Application - Independent

Definition: independent of any organization with a Master Agreement in place with the Calgary Board of Education. Thanks for completing this form. All the information below will be used to update our Artist Roster for principals and teachers. Please print clearly.

Artist Contact Information
First Name / Last Name / Phone No.
Email / Website/Blog / Cell No.
Date of Application / Cost per Time/Unit / GST #
Language spoken / Preferred grades to work with (check all boxes that apply) / Format preference / Discipline
(check all boxes that apply)
☐ English
☐ French
☐ Other / ☐ Kindergarten
☐ Grade 1-3
☐ Grades 4-6
☐ Grades 7-9
☐ Grades 10-12 / ☐ Workshop
☐ Residency
☐ Performance
☐ Lecture/Demonstration
☐ Other / ☐ Dance
☐ Drama
☐ Literary Arts
☐ Media Arts / ☐ Music
☐ Visual Arts
☐ Multimedia
☐ Other
Within your discipline, what do you want to share with students? Keywords are ideal. E.g. within media arts enjoy watercolour, oil, illustration, jazz, tap, etc. / References including phone numbers
Reference name:
Contact info:
------
Reference name:
Contact info:
------
Reference name:
Contact info:
Conditions to work in schools - copies must be submitted with application:
Worker Compensation Coverage
☐ Yes ☐ No
Provide WCB letter of coverage/denial / Police Information Check | Vulnerable Sector Check
Clearance dated:
Have you been charged with a criminal offense which you have not been pardoned for:
☐ Yes ☐ No
Insurance Company
Provide Insurance Certificate that includes statement “CBE included as additional insured”
Artist Biography | 150 words maximum. See note below re: photo requirement.
Artist Statement | What the artist has to offer to schools, staff, and students? Knowledge - artistic competence, skills, attitudes, perspectives, connections, curriculum integration, collaboration, creativity, design. (max 50 words)
Previous Residences and Art Associations
Example of Work | Include any web or video links here.

I acknowledge any information accessed, collected, used, generated, or stored while performing the service for the Calgary Board of Education, including student, instructional, financial, or administrative information, is strictly confidential and is to be used only in the provision of services. I will not disclose, communicate, publish, take, alter copy, interfere with, or destroy any information unless specifically authorized to do so. For further information, please contact the Fine & Performing Art Specialist 403-817-7607 or email .

Submit your completed application form along with your photo (jpg format) to .

June 2015Learning ServicesPage 1 | 1