P-12 ›› Prekindergarten through Grade 12 Education

P-12

Data Collection Forms

* = required field

First Name*:
Last Name*:
Mailing Address:
City:
State:
Zip Code:	-
Email:
Home Phone: (123) 456-7890
Work Phone: (123) 456-7890
Name at time of attending school:
First Name*:
Last Name*:

Which program(s) and what year(s) did you attend*?
Program	Year	Math & Science Institute site

Select Current Educational Status

Other Study/Training:

Please indicate any major or minor in the Arts while attending a postsecondary institution.
Major:

Minor:

Course of study if other than Arts oriented:

Did you enter a profession involving your applicable field?
Yes (Please describe your position and responsibilities):

No (Please describe the profession you are in and the nature of your responsibilities):

Did attending the Summer School of the Arts program influence your decision to pursue Arts as a career?
Yes No
How great an effect did your attendance at the Summer School of the Arts have on you in the following areas:
1. The opportunity to evaluate your skills as compared to other students in your age group.
2. Inspiration and encouragement you received from instructional and counseling staff.
3. The opportunity to experience an intensive study program under professionals in the field.
4. Other (Please describe)

What are you doing now?

Please add additional comments about your participation in the Summer School of the Arts and how it may have influenced you.

Please verify the items listed below that you give permission to list on the web site.
Name*	Yes No
Address information (street, city, state, zip)*	Yes No
Home Phone*	Yes No
Work Phone*	Yes No
Email Address*	Yes No
What you are doing now*	Yes No
Additional comments about your participation*	Yes No

Last Updated: April 16, 2010