UTLA Arts Education Committee Members
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PERSONAL & CONTACT INFORMATION
Last name *
First name *
Middle name or initial *
If none, please indicate.
Your LAUSD employee number
 *
Personal email address *
Please enter ONLY a NON-lausd.net address
Home phone number *
If none, please indicate.
Mobile/text number *
If none, please indicate.
Preferred phone number for Arts Ed Committee communications *
Preferred mode of written communication for Arts Ed Committee communications *
Do you give your permission to share your contact information with other Arts Ed Committee members for collaboration purposes? *
Check all that apply
Required
Where do you live? *
If you live within LAUSD boundaries, please indicate in which Board of Education District (BD) you live, or indicate if you live outside District boundaries. To access a map of LAUSD Board Districts, click this link: https://tinyurl.com/BoardofEdDistricts2023
In which local neighborhood within the City of Los Angeles, or other city inside or outside of LAUSD boundaries, do you live? *
If you'd rather not disclose this information, feel free to write "DTS" (decline to state)
Are you a parent? If so, do you have children who attend LAUSD schools? *
Check all that apply
Required
ARTS DISCIPLINE
Which arts discipline(s) do you teach? *
Check all that apply. If you aren't currently teaching one of the five core arts disciplines, or you're an arts advocate in a different position, please indicate.
Required
Do you have a speciality(ies) within an arts discipline(s)? *
Check all that apply and/or add another speciality(ies) that is/are not listed.
Required
Which credential(s) and authorization(s) do you hold? *
If you hold more than one credential and/or authorization, please hit the "return" key and list each credential on a new line. If you are a pre-service teacher, please indicate.
If you hold a service credential and/or license, rather than or in addition to a teaching credential, please state. Also include whether you hold National Board Certification and any admin credential that you hold.
SCHOOL ASSIGNMENT, GRADE LEVEL(S), & POSITION
In which school(s) do you teach/work? *
Please use the full title of the school rather than abbreviations. If you are assigned to the Itinerant Elementary Arts Program, please state as such and name each assigned school (please hit the "return" key and list each school on a new line). If you are a pre-service teacher, please indicate in which credential program that you're enrolled and school(s) that you may be student teaching.
In which District Region is your assigned school(s) located? *
If you are assigned to more than one school, in more than one Region, check all that apply. To access maps of LAUSD Regions, click this link: https://achieve.lausd.net/Page/18933
Required
In which Board of Education District is your school(s) located?
 *
Please indicate in which Board of Education District (BD) your school(s) is/are located. If you are assigned to more than one school, in more than one BD, please check all that apply. To access maps of LAUSD Board Districts, click this link: https://tinyurl.com/RegionsWithBoardOverlay2023
Required
Which grade level(s) of students do you currently work with? *
Check all that apply
Required
For how many years have you been an employee of LAUSD? *
ENGAGEMENT with the ARTS ED COMMITTEE, UTLA, AFFILIATED UNIONS, & ARTS ED ORGANIZATIONS
Within which UTLA Area is your school(s) located? *
Please note that there are 8 UTLA Areas and they are different from the 4 LAUSD Regions. If you are assigned to more than one school, check all that apply, or indicate "not sure".
Required
In what ways have you engaged, and/or would you like to engage, locally, statewide, and/or nationally? *
Please check all that apply
Required
In what ways would you like to engage with the Arts Education Committee? *
If you're not sure at this time, feel free to state "not sure" or N/A.
What LAUSD arts-specific issues and/or concerns about your arts program specifically do you feel could be addressed by the Arts Ed Committee? *
If you're not sure at this time, feel free to state "not sure" or N/A.
What are some of your ideas for ways that the Arts Ed Committee can support Arts Education locally, statewide, and/or nationally? *
If you're not sure at this time, feel free to state "not sure" or N/A.
Anything else that you'd like to share?
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