Arts-In-Education(Eastern Suffolk BOCES)

*SCHOOL DISTRICT:

*BLDG:

*SCHOOL CONTACT:

*EMAIL:

TEL:

*NAME OF ARTIST/ORGANIZATION:
*NAME OF PROGRAM:
*CONNECTION TO ARTS STANDARDS: How are the arts incorporated into this program?
PERFORMANCE (In school/off Site)RESIDENCYWORKSHOPFIELD STUDYVC
ART FORM: _____________

THIS FORM MUST BE SUBMITTED ONE MONTH IN ADVANCE OR PERFORMANCE DATE.
*****PRE-PAYS REQUIRE FORM AT LEAST 5 WEEKS IN ADVANCE. CONTRACT WILL NOT BE ISSUED WITHOUT SCHOOL DISTRICT COORDINATOR'S SIGNATURE.

*DATE(S):	OTHER DATE(S):
*TIMES(S):
# OF PERFORMANCES:	AND/OR WORKSHOPS:
*GRADE LEVEL(S):
SCHOOL BUILDING(S):
OUT OF DISTRICT?	NOYES	IF YES, WHAT LOCATION?

* ARTIST/ORGANIZATION FEE:
(Please do not include coordination fee)		(If different that catalogue, please check and explain)

***Please hit submit button only one time OR you will be authorizing multiple contracts.***

***Please note that authorized school personnel is required to be in attendance with students during all presentations.***