Name *

First Name

Last Name

Phone *

(###)

###

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Which artistic disciplines are you interested in? *

Check all that apply.

Comics and Illustration

Film/Video

Music

Literature

Performing Arts

Visual Art

Other

Are you a practicing artist? *

Yes

No

Not sure

Race or Ethnicity

Check all that apply

East Asian

SWANA/West Asian

Pacific Islander

South Asian

Southeast Asian

Mixed

Other