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Person

Organization

Program

Post

Page

Donate
Events
Blog
Contact

Programs
Street Level
Teen Arts Pass
About
People
Support
- Support Us
- Donate Now!
- Ways to Give
- Donors
- Funders
- Blog
Contact (HIDDEN)

Residency Program Request

Residency Program Request

Tell us about yourself:

First Name:

Last Name:

School / Organization Name:

Your Title or Role:

Telephone:

Email:

Tell us about your school / organization:

Street Address - Line 1:

Street Address - Line 2:

City:

State:

Zip Code:

Tell us what art form you're interested in:

Media Arts - Examples: video production, photography, sound mixingPerforming Arts - Examples: dance, music, theater, storytellingVisual Arts - Examples: drawing, painting, mosaics, textilesOther Art Forms

Tell us a few more details:

If you have preferred dates or times of year for a program, please list below:

Examples: October 9th and 12th, April to June 2018, etc.

Indicate Age Range or Grades:

Number of Classrooms:

Number of visits per week:

Estimated Budget:

Preferred day(s):

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Preferred time(s):

Morning (8:00am-12:00pm)Afternoon (12:00-3:00pm)Late Afternoon (3:00pm-6:00pm)Evening (6:00pm or later)

Tell us any other information you feel we should know:

What are your desired outcomes for a partnership/collaboration with Urban Gateways?

What questions/comments do you have for Urban Gateways?

How did you hear about Urban Gateways?

Residency Program

Residency Program

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Urban Gateways Administrative Office:
100 S State St Floor 4
Chicago, IL 60603

312.922.0440

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