OFFRE DE SERVICE (Artiste)

Departments of Education and Early Childhood Development

and Tourism, Heritage and Culture

NOTE: All fields must be filled out for the candidacy to be considered.

Name:______

Address:______Municipality:______Postal Code: ______Telephone: ______Email: ______

Website: ______Facebook: ______

Twitter: @______Instagram: @______

…………………………………………………………………………………………………………………………….

Considered Professional Artist? YES _____NO _____
*Please attach your resume if you are not a member of a recognized arts organizations such as: ArtsLink, AAAPNB, NB Crafts Council or Music NB, etc. OR have not previously received a grant from the New Brunswick Arts Board.

Artistic Discipline(s):

___ Music ___ Media Arts (Film/video, new media)

___ Dance___ Visual Arts (painting, pottery, craft, sculpture)

___ Literary Arts(Writing, storytelling, poetry)___ Theatre Arts

___ Multidisciplinary *please specify: ______

Space / material requirements:______

…………………………………………………………………………………………………………………………….

Which grade level would you prefer working with?___ Elementary (K-5)___ Middle (6-8)

___ High School (9-12)___ All Levels (K-12)

Do you identify as an Indigenous artist? YES _____NO _____

This information will help schools interested in working with Indigenous artists to connect with those who have identified themselves as an Indigenous artist.

Are you able to provide a residency in French?YES _____NO _____

This information will help schools to connect with Francophone artists or French speaking artists. This would be useful for French immersion classes who are interested in a residency provided in French.

Preferred School District(s): (check all that apply)

[ ] Anglophone School District - East Moncton, Riverview, Salisbury, Sackville(Formerly District 2)

[ ] Anglophone School District- South Rothesay, Hampton, Sussex, Saint John, Grand-Bay, St. Martins,

St. Stephens, St. Andrews, St. George (Formerly Districts 6, 8, 10)

[ ] Anglophone School District- North Bathurst, Dalhousie, Campbellton, Miramichi, Blackville, Rexton (Formerly

Districts 15, 16)

[ ] Anglophone School District - West Perth-Andover, Woodstock, Oromocto, Chipman, Minto, Fredericton, Harvey

Station, Boiestown (Formerly Districts 14, 17, 18)

[ ] First Nation Band-Operated Schools Listuguj (QC), Fredericton, Elsipogtog, Esgenoopetitj, Tobique First Nation,

Red Bank, Eel Ground

Artist’s Bio (max. 100 words) and attach Headshot/Photo (JPG format):

______

RESIDENCY PROJECT -Please provide an example of an arts project you would like to carry out in a classroom.
(max. 200 words)

______

TEACHING EXPERIENCE - Do you have any experience teaching a group of students? If yes, please explain:
(max. 100 words)

______

Note:

• Districts require you to familiarize yourself with “Policy 701 – Policy for the Protection of Pupil” and to successfully complete and submit a copy of the signed “Policy 701 Validation Questionnaire Results” which can be accessed here. ***Please include a signed copy of your Policy 701 Validation Questionnaire certificate showing a 100% pass score with this form.
• Failure to comply with the requirements of this program could result in your name being removed from the registry and refusal from future participation in the program.
• Upon acceptance, inclusion for artist registry will be valid for 3 years. After 3 years, artists must re-submit.

Application Checklist:

• Completed application form
• Resume if not a member of an arts organization or have not received an artsNB grant
• Bio & Headshot/photo (attach JPG)
• Signed copy of Policy 701 Validation Questionnaire certificate

Please email this application to .

Revised: April 2018