Michigan Economic Development Corporation

Michigan Council for Arts and Cultural Affairs

Panelist Nomination Form

Panelist Nomination Form
Name
Address
City
State
Zip Code
Phone
Disciplinary Expertise
Chamber Choral/Vocal Dance
Humanities Jazz/Blues Literature
Media Arts Multidisciplinary Opera/Musical Theater
Orchestra/Band Photography Theater
Traditional Arts Visual Arts    
None of the above (list appropriate discipline) 
Have you previously served as a Peer Review Panelist?
Yes     No
Which Organization?   
Which Year?   
Experience (check the appropriate answer(s))
Advertising / Marketing / Promotion Arts Administration
Arts Education Arts/Cultural Research
Arts & Humanities Arts & Technology
Arts or Cultural Fair / Festival Management Capital Improvements / Facilities Construction
Collaborative Programs / Partnerships Community-Based Program Development
Curriculum Development / Fund Raising
Development Publishing Historical Programs
Local Arts Organization Development Programs for Persons with Disabilities
Science Touring / Presenting
Youth Programs Zoological Programs
For required reporting purposes only, MCACA requests that perspective panelists select the appropriate ethnicity.
In the space provided, submit a brief biography (include formal and informal education as appropriate, as well as pertinent experience).