PROGRAM APPLICATION

Please take a moment to complete the application below. Artreach is interested in serving every part of Chicago's community that needs art programs-schools, churches, senior centers, and individual or family communities.
We are here to assist in two ways - to travel to you or provide in-house classes at Lillstreet Art Center.

(This is not an application for employment.)
If you wish to fill out an employment/volunteer application, please click here.


Organization
Primary Contact Person
Address Line 1
Address Line 2 optional
City & State
ZIP	-

Telephone	( ) - ext.
Fax	( ) -
E-Mail
Preferred method of contact

We ask that you fill out an estimated date for your desired program.

enter a date (mm-dd-yy)	- - Time:

Age of Students
Total # of Students
Total # of Chaperones (adults not participating in the program)
Total # of Adults participating in the program, if any	(an additional fee applies)
Class Type (see our program list for options or describe your program). VIEW PROGRAMS IN a new window
Do you want to hold this program...	at your facility? at Lillstreet?
Additional Comments (please include the length of time you desire this course.)

All information submitted will remain confidential and will not be shared or sold to any third parties.