ARTIST REGISTRATION FORM

Full Name:
Date of Birth:
Business Name:
Full Address:
Phone:
Email Address:
Website:
Area or Artistry:
Years:
Professional /Published Artisty:
Novice Artist:
Please describe your work, including past projects or exhibits:
Chester Arts Alive! is an artist member serving organization. Please select the areas in which you would like to learn more about or expand your capacity as it relates to your art career: (Please check all that apply)
Artist Development Representation and Management
Event and Performance Refferral List
Artist Workshops and Technical Assistance
Community Resources, Projects, Collaborations
Consulting
How did you hear about Chester Arts Alive?
If interested in being a part of CAA’s Artist Referral System, please list your availability:
MONDAY
AM
PM
TUESDAY
AM
PM
WEDNESDAY
AM
PM
THURSDAY
AM
PM
FRIDAY
AM
PM
SATURDAY
AM
PM
SUNDAY
AM
PM
I certify that the information in the application is true and complete to the best of my knowledge and I understand that inaccurate information may affect my enrollment status. Further, I authorize my schools to release my transcripts of my school record and any other pertinent information, should Chester Arts Alive find it necessary. If my enrollment is accepted, and I become a participant of Chester Arts Alive program, I will abide by its rules and regulations.
By initialing here I certify that I have read and understand the rules and regulations listed above:

*Once you submit your application you will receive an email with a link to pay your Annual Membership Fee of $99.00. This payment MUST BE MADE for your application to be completely processed.

(If you are having trouble completing this form, CLICK HERE to download it now.)

Captcha Code:
Captcha Code