Heart Space - Teen Participation Questionnaire 
This form is being used to gather information from local teens who would like to participate in workshops, open studio and other activities in the arts at Heart Space - an art space for teens on Hatteras Island.  The information gathered will help us assess the creative wants and needs of our young community.  It will also build our contact list so that we may share info about upcoming workshops and opportunities with you.   Note that we hope to secure enough funding to provide these classes and workshops free of cost to local teens. 
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First & Last Name *
Age
Birthdate
MM
/
DD
/
YYYY
Phone
Email
What is the best way to reach you?
Clear selection
In what area of the arts are you interested? (check all that apply)
Tell us more about your creative interests.  How/what do you enjoy creating?  What would you like to learn more about?  Feel free to be as specific as you like.  We will use this information to help plan classes and workshops.
Are you interested in classes and workshops?
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Are you interested in unstructured open studio time or in the possibility of reserving studio space?
Clear selection
Are you interested in volunteer opportunities?
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If you could choose any artist to teach a workshop in any medium or area of the arts, who would it be?
If you could ask for any art, creativity or wellness workshop, what would it be?
What skills do you have that might be helpful to a community art space?  Name at least three (I know you have them) - two expected and one unexpected.  In other words, at least one obscure skill that we didn't even know we needed. 
What are the best days and times for you to be able to participate in arts programs at Heart Space?
What did I forget?  Please share any additional ideas, thoughts and questions.  Also, thank you for getting this far!
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