Art Economic Empowerment Initiative Sign Up Form (Cohort I:  July 2022 - December 2022)
Complete the entire form.  Incomplete forms will result in disqualification from program selection.  Slots are limited, this is first come first serve.  To qualify you must be a Pennsylvania resident.   Deadline is 06.30.22 11:59PM EST.  For any questions, send an email to
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Email *
Preferred First & Last Name *
Telephone Number *
City & State *
Zip Code *
List your congressional district number?  (To find your district go to *
Check the box/boxes that best describes your artistic discipline(s). *
Check the box that best identifies the stage you are today in your artistic career. *
Race/Ethnicity *
Pronouns *
Do you identify as transgender? *
List Your Generation *
Do you identify as a person with a disability? *
List any accessibility accommodations, if needed.
All sessions will be virtual.  Are you able to fully commit to the listed dates and times?  Cohort I:  July 20, 2022 6:00pm - 8:30pm EST; August 24, 2022 6:00pm - 8:30pm EST; September 21, 2022 6:00pm - 8:30pm EST; October 19, 2022 6:00pm - 8:30pm EST; November 23, 2022 6:00pm - 8:30pm EST; & December 21, 2022 6:00pm - 8:30pm EST                             (*Note - You must complete all sessions in order to receive the stipend and certificate of completion.) *
How did you hear about the Art Economic Empowerment Initiative? *
Have you participated in any past workshops/webinars with The Women's Coalition for Empowerment, Inc.? *
If selected to participate in the AEEI, will you commit to the entire program? *
What do you hope to gain from the Art Economic Empowerment Initiative (AEEI)? *
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