New Studio Form
Tell us more about your needs, resources, and interests so that we can know how to best support the collaborative creation of a media lab in your community.
Sign in to Google to save your progress. Learn more
Email *
Name of Applicant *
Proposed Country Location: *
Region & general information of the area such as: What are the main challenges in your community? *
Name and Description of community/population to be served: *
Is there a school or community center that you can partner with to house the media lab? The location where the culture program will take place, including background information about the area and living conditions. Include contact information for the location, and why this program is needed. There must be a safe place for the studio to be housed: *
How will you maintain safety & security of the media lab? *
Is there electricity that can be purchased nearby, or will this studio need it’s own solar power? Is there internet service in the area, and if so, how much does it cost each month? *
When would it be possible for programming to take place? What day and how many times weekly would be the best match? *
How many kids would be served in the initial program? What is the age range of the youth? *
What are existing community resources or organizations that could assist in the implementation or support a media studio lab (ex: local music school)? *
How will this studio strengthen the community? *
Identify key members of the community who have an interest in and dedication to sustaining the media lab: *
Identify potential studio stewards in the community who have prior experience teaching or working with youth, and include their contact information: *
Possible places locally to obtain equipment or have crafted by local artisans: *
Project Needs and Expenses:  Estimated costs: *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of LEAF Global Arts.

Does this form look suspicious? Report

Google Forms