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Florida Division of Arts & Culture: 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.
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Nominee Information
Please use this section to provide information about the person or persons you would like to nominate as a panelist.
First & Last Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Race/Ethnicity
Please choose the option that describes the nominee to the best of your knowledge.
American Indian/Alaska Native
Asian
Black/African American
Hispanic/Latino
Native Hawaiin/Pacific Islander
White
Other:
Clear selection
Sex
Male
Female
Clear selection
Florida County or Other 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
Community Theatre
Dance
Individual Artist Project
Local Arts Agency/State Service Organization
Literature
Media Arts
Multidisciplinary
Museum
Music
Presenter
Professional Theatre
Traditional Arts
Visual Art
Underserved Cultural Community Development
Required
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
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