School or Organization
Physical Address (if different)
Have you hosted an Art Center East AiRs experience before?
What are the approximate dates of the most recent booking?
Name of On-Site coordinator (the On-Site Coordinator is responsible for coordinating all aspects of the AiRS program at your school, including scheduling, ordering supplies as necessary, and securing lodging.)
Site Coordinator's Position
Site Coordinator's Telephone
Best time to call
Name of authorizing agent (Principal, Superintendent, etc.)
Name of the sponsoring agent (PTO, PTA, parent club, etc.)
Contact person for sponsoring agent
E-mail address for sponsoring agent, for billing purposes
The number of weeks requested:
Please list your top three Teaching Artist Preferences:
Please list your top three preferences for residency dates:
Please indicate grade levels who will participate in the residency
The number of students participating
The number of teachers participating
The number of volunteers participating
List any other special groups that will participate (gifted, special needs, ESL, etc.)
If you are a teacher or superintendent please complete this section
As a teacher/ superintendent, what do you hope to learn by participating in this residency?
Why do you believe teachers will benefit from the residency?
What specific learning objectives do you expect the students to achieve? What are your learning targets?
Why do you believe students will benefit from the residency?
How will other curricular connections be integrated into the residency?
In what ways will this residency support the Oregon Arts Content Standards?
Does your school use arts-based learning or art education as part of your curriculum
Please list, and state how your teachers currently incorporate art (as defined by the Oregon Arts Content Standards) into their curricula.
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1006 Penn Ave
La Grande, OR 97850
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