Baltimore City Public Schools 2021–2022 Your Name* First Last Job Title* School Name* School Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School Phone*Your Email* Your Cell PhoneNumber of students in your school*Is there an art form that most interests you? If so, what is it? Do you know which artist you would like to work with? If so, who is it? Do you know whether a residency, an assembly, or a professional development, would best align with your goals for the program? If so, what are you thinking?Would it be helpful for someone from the program team to reach out by phone or email to discuss artists and program types?*YesNoSCHOOL BUDGETYour school is responsible for paying a portion of the program cost. We can provide programming costs before or after the award at your request. You may choose to use Arts Every Day and/or ESSER funds to pay the school program cost. Please select one amount or more that works for your school or describe your funding needs below. $0-$100 $101-$200 $201-$300 $301-$400 $401-$500 More than $500 Please describe your funding needs below.Additional InformationIs there anything that did not fit into any of the questions above that you would like the panel to know about your school? If would like to attach a document instead please do that below.Please attach any additional documents here.Max. file size: 100 MB.Principal ApprovalPrincipal Name* First Last Principal Signature*PhoneThis field is for validation purposes and should be left unchanged.
