Call for Classrooms

2017-2018 School Year

Adaptation, Integration, and the Arts

ApplicationForm

Successful applications are clear, persuasive and demonstrate a true interest in, and preparation for, supporting an arts-integrated residency that hosts a teaching artist at your school site. This also means understanding that the primary audience is students with disabilities (qualifying IEPs). Typical peers and educators are the secondary audience.

Teachers should understand this is a partnership requiring effort, engagement, and enthusiasm – not an opportunity for a break while the artist is on site.

Direct Questions & Return Application Form to:

Erin J. Hoppe

614-241-5325

VSA Ohio

77 South High Street, Floor 2

Columbus, OH 43215

This document must be typed.

One sentence answers are not acceptable,

and the form should expand to additional pages.

School Demographics

School Name:

Full Address:

District Name:

County:

Phone Number:

School Website:

Statistics:____% of student body with documented disabilities

(Including IEPs; poverty is NOT to be considered a disability)

____% of student body receiving free/reduced lunch/poverty level

Ethnic Breakdown:____% White, non-Hispanic____% African American

____% Hispanic/Latino____% Asian

____% Other

Location: Urban  SuburbanRural

Type: Public  PrivateSpecialized

School Start & End Dates:

Grade Level/s to serve:

Proposed Number of Classrooms:

Estimated Number of Students served:

Estimated Number of Students with Disabilities to be served:

*At least one-third (1/3) of total participants.

Estimated Number of Low Income Students to be served:

Answers must be typed and should use as much space as necessary to adequately answer questions. Applications lacking detail do not demonstrate a commitment to the program or understanding of its purpose and are difficult to assess.

  1. Statement of Need. Why is an artsresidency right for your school?
  1. How can educators and school administrators ensure the success of an artist in residence?
  1. What adaptations are made by your school to serve students with disabilities in inclusive settings?
  1. How will students with disabilities be included in the residency? Students with disabilities need to have an Individualized Education Plan and should represent at least one-third (1/3) of participants.
  1. Each AIA residency is uniquely designed to meet the content and scheduling needs at a school. Some sites are open to any creative projects. Others have specific ideas for goals they want to address, timing, art forms, etc. Please use this space to describe any and all residency ideasyour team has discussed.
  1. AIA is committed to investing in the professional development (PD) of educators in the use of artsintegration and Universal Design for Learning. Schools are asked to commit to the time and space for hosting individual, small group or school-wide professional development opportunities led by the artist in residence or another.

Is the Administration supportive of a PD component? Yes No

  1. Proposed duration of Residency

2- 3 weeks 5- 6 weeks 10-12 weeks

 Semester  Full year  Other:

  1. Preferred timing of the Residency (ex. Full Year, Fall, April).
  1. Art Area/s of Interest

___ Dance ___Drama ___Visual Art

___Music ___ Other:

  1. School and/or classroom Content Area goals for the upcoming year.

___ Language Arts ___ Math ___ Science

___ Social Studies ___ Foreign Language ___ Other:

  1. Proposed Teaching Artist & Contact Information

Some schools have a specific teaching artist in mind as a partner. That person’s name and contact information should be provided here. Each Teaching Artist must complete the VSA Ohio AIA Teaching Artist Application before they can be engaged. Suggestions are not required, nor do they guarantee selection.

Proposed ParticipantsAssurance Signatures

Administrator

Signature
Name
Title
Email

Teacher #1

Signature
Name
Title
Email

Teacher #2

Signature
Name
Title
Email

**By signing this document all parties acknowledge they have read and understand the timeline, expectations, and fine print associated with this application. All parties acknowledge they understand the application content submitted by the school. All parties will adhere to program policies, including communication, participation, and evaluation. VSA Ohio reserves the right to request additional information and select all Adaptation, Integration and the Arts sites. Any determinations, agreements and implementation are strictly dependent on VSA Ohio’s receipt of funding and may be cancelled at any time.