Artists Respond Reviewer/Panelist Interest Survey Connecticut Office of the Arts (COA)Artists Respond Reviewer/Panelist Interest Survey Please take a moment to complete the survey questions below if you are interested in serving as a reviewer/panelist for COA's Artists Respond Program. OK Question Title * 1. Enter your contact information Name Organization/Institutional affiliation (if applicable) Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Website (if applicable) Email Address Phone Number OK Question Title * 2. Check All that Apply: Your role in the Arts Administrator Artist Curator Educator Producer Other (please specify) OK Question Title * 3. Arts Expertise: Primary Arts Discipline Community / Teaching Film / Digital Media Literary Arts Performing Arts - Dance Performing Arts - Music Performing Arts - Theatre Visual Arts Design Other (please specify) OK Question Title * 4. Arts Expertise: Secondary Arts Discipline Ballet Choreography Classical Music Community / Teaching Arts Crafts Creative Non-Fiction Graphic Design Folk & Traditional Arts Fiction Jazz / Blues Illustration Installation Mixed Media Modern / Contemporary Dance Music Composition Musicals New Media Painting Performance Art Photography Playwriting Poetry Pop Music Screenwriting Sculpture Spoken Word Young Readers Other (please specify) OK Question Title * 5. Previous experience as a grant reviewer Yes No Please specify OK Question Title * 6. Tell us about your experience and qualifications relevant to the arts and/or include a short bio. OK Question Title * 7. Briefly tell us why you are interested in serving as a reviewer for COA's Artists Respond program. OK DONE