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ChopArt Creative Toolkit Program – Shelter Inquiry Form
Thank you for your interest in the Creative Toolkit program. Please complete this form to begin the process of bringing the program to your teens. If you have any questions, please contact info@chopart.org or visit
www.chopart.co
for more information.
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Contact Information
Shelter Name
*
Your answer
Primary Contact Name
*
Your answer
Contact Email
*
Your answer
Phone Number
*
Your answer
Program Logistics
Estimated Number of Teen Participants (Middle & High School-aged)
*
Your answer
Days of the Week That Work Best for Programming
*
Your answer
Days and Times That Work Best for an Introductory Session
*
Your answer
Any Special Onboarding Requirements for Your Organization
*
Your answer
Clinical Alignment
For example: emotional regulation, anxiety, ADHD, attachment challenges, etc.
Are there consistent themes or specific issues in your teens’ treatment plans we should be aware of when finalizing the curriculum?
*
Your answer
Future Partnership
Are you interested in learning more about other ChopArt opportunities for your youth?
*
Field Trips
Camp Envision (Weeklong Overnight Performing Arts Camp)
Ongoing Mentorship/Leadership Programs
Not at this time
Required
Thank you for your interest in partnering with ChopArt. We’ll be in touch soon to schedule next steps!
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