17.07.2015 Views

Application Form: Teaching Artist Roster - Mississippi Arts Commission

Application Form: Teaching Artist Roster - Mississippi Arts Commission

Application Form: Teaching Artist Roster - Mississippi Arts Commission

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20. Professional Development Workshops for:K-12 Teachers:Other <strong>Artist</strong>s:21. Special Populations with whom you have worked:At-Risk Students:Incarcerated Youth:Students w/ special needs:ESL (English as Second Language):Seniors:Healthcare:Other:CertificationI certify that the information contained in this application, including all attachments, is true and accurate.Signature of applicant in inkDatePlease have your application postmarked and in the mail no later than March 3, 2014.Send it to:<strong>Mississippi</strong> <strong>Arts</strong> <strong>Commission</strong>501 North West StreetSuite 1101A, Woolfolk BuildingJackson, MS 39201<strong>Mississippi</strong> <strong>Arts</strong> <strong>Commission</strong> - <strong>Teaching</strong> <strong>Artist</strong> <strong>Roster</strong> <strong>Application</strong>, p. 2 of 5

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