Florida Division of Cultural Affairs: Panelist Nomination Form
To nominate a panelist for an upcoming panel meeting, please supply the information in the field below. Please feel free to direct questions to the Division at 850.245.6470.
* Required
Nominee Information
First & Last Name
*
Your answer
Email Address
*
Your answer
Sex
Male
Female
Clear selection
Race
Please chose the option that best describes the nominee
American Indian/Alaska Native
Asian
Black/African American
Hispanic/Latino
Native Hawaiin/Pacific Islander
White
Other:
Clear selection
County/State
*
Please provide the county the nominee resides in. If out-of-state, please provide the state.
Your answer
Current Place of Employment
*
Your answer
What panels could this nominee review applications for?
Please check all that apply.
Arts in Education
Dance
Folk Arts
Local Arts Agencies
Media Arts
Multidisciplinary
Museums
Music
Presenter
State Service Organizations
Theatre (Community)
Theatre (Professional)
Touring Roster
Underserved
Visual Arts
Bio
*
Please provide a brief bio detailing relevant experience in the field.
Your answer
Additional Information
If there's anything else you'd like to include, please let us know!
Your answer
Nominator
The information below is optional.
Nominator Name
Your answer
Nominator Email Address
Your answer
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