Community Insight Registration Maywood

Community Insight Registration
Maywood

Stairway of the Stars Dance Studio - Maywood Fine Arts

20 N 5th Ave, Maywood, IL

Wednesday, October 15 • 9:00am-1:00pm

Thank you for your interest in joining us for one of our Community Insight sessions! Please use the form below to register.

To help provide insight into the demographics of the creative sector, the registration asks for information on ZIP codes, racial demographics, and age. No personal information will be shared with government partners or other stakeholders in Cook County Arts.

Click here to return to the Community Insight session webpage.

First Name

Last Name

Email Address

Is this email mainly for personal or work use?

PersonalWork

ZIP Code

Is that ZIP code mainly affiliated with your home or work address?

HomeWorkOther

What is your relationship to the creative sector?

For-Profit Creative BusinessIndividual ArtistArts and Culture NonprofitLocal Government EmployeeResident

Do you have a specific artistic discipline or focus?

Advertising / PR / Marketing	Architecture
Arts Service / Local Arts Council	Art Therapy
Comedy / Improv	Community / Cultural Centers
Cultural Heritage and History	Dance
Education / Youth Development	Fashion Design
Film	Folk and Traditional Arts and Crafts
Graphic Design	Literary Arts / Publishing
Makerspace / Incubator	Music
Opera	Performing Arts Venues
Photography	Radio & Television Broadcasting
Theatre	Virtual Art and New Media
Visual Arts	Zoos / Botanical / Aquarium
Prefer Not to Say	N/A

Personal Identifiers

Do you identify as any of the following? Select all that may apply.

African / African American / BlackArab / Middle Eastern / North AfricanAsian / Pacific IslanderLatino / Latina / LatinxMultiracialNative American / Indigenous / American IndianWhitePrefer Not to Say

How old are you?

Under 25 years old25-34 years old35-44 years old45-54 years old55-64 years oldOver 65 years oldPrefer not to say

Do you have any dietary restrictions we should be aware of?

N/AVegetarianVeganPescatarianNon-DairyGluten IntoleranceKosherHalalOther

Other:

I will need the following accommodations to participate:

What do you hope comes out of these community sessions?

Hidden Admin Fields

Campaign ID