MHAL - Panelist Nomination Form

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Panelist Nomination Form

Disciplinary Expertise

	Chamber	Choral/Vocal	Dance
	Humanities	Jazz/Blues	Literature
	Media Arts	Multidisciplinary	Opera/Musical theater
	Orchestra/Band	Photography	Theater
	Traditional Arts	Visual Arts
None of the above (list appropriate discipline)

Have you previously served as a Peer Review Panelist
Yes No

For what Organization

What year

Experience (check the appropriate answer/s)

	Advertising/Marketing /Promotion		Arts Administration
	Arts Education		Arts/Cultural Research
	Arts & Humanities		Arts & Technology
	Arts or Cultural fair /festival management		Capital Improvements / Facilities Construction
	Collaborative Programs / Partnerships		Community based program development
	Curriculum		Development/Fund raising
	Development Publishing		Historical Programs
	Local Arts Organization development		Programs for persons with disabilities
	Science		Touring / Presenting
	Youth Programs		Zoological Programs

For required reporting purposes only, MCACA requests that perspective panelists select the appropriate ethnicity.

In the space provided, submit a brief biography (include formal and informal education as appropriate, as well as pertinent experience).

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