ArtWeek 2019: Art of Food Application Thank you for your interest in applying to be a part of ArtWeek 2019's Art of Food initiative! Please provide the following information: OK Question Title * 1. Name of your restaurant and/or establishment: OK Question Title * 2. Please provide the PRIMARY CONTACT information: FIRST NAME LAST NAME TITLE EMAIL ADDRESS PHONE NUMBER OK Question Title * 3. Please provide the mailing address of your restaurant and/or establishment: STREET 1 STREET 2 (unit, etc.) CITY STATE ZIPCODE OK Question Title * 4. Which Massachusetts region do you fall within (pick one): Cape Cod & The Islands Central Massachusetts Greater Boston North of Boston South of Boston Western Massachusetts OK Question Title * 5. Please list all of your website information and social media handles: Website URL Facebook Handle Instagram Handle Twitter Handle OK Question Title * 6. If you would like the Chef/Creator of the dish listed, please provide their name: OK Question Title * 7. Will you be serving: Appetizer Entree Dessert Beverage Other (please specify) OK Question Title * 8. Please describe your offering and its ArtWeek inspiration here: OK Question Title * 9. How would you describe your ArtWeek involvement? New Returning OK Question Title * 10. Which days of ArtWeek 2019 will this be served? (please click all that apply) Friday, April 26 Saturday, April 27 Sunday, April 28 Monday, April 29 Tuesday, April 30 Wednesday, May 1 Thursday, May 2 Friday, May 3 Saturday, May 4 Sunday, May 5 OK Question Title * 11. Will you be donating any proceeds to ArtWeek in Schools from your Art of Food specialty? Yes No Not sure at this time OK Question Title * 12. Press and Marketing: Please feel free to add names/contact information of local and other media that has been receptive to your press/marketing efforts in the past so that we can add it to our ArtWeek outreach! OK Question Title * 13. Additional Comments: OK Question Title * 14. By checking this box, I agree to cross-promote with ArtWeek and Art of Food via social media efforts. I AGREE I do not agree - please contact me for information OK Question Title * 15. By checking this box, I authorize ArtWeek the irrevocable and unrestricted right to use and publish the images and logo provided for promotional purposes. I hereby waive the right to receive any payment for use of any materials provided to ArtWeek. I AGREE I do not agree - please contact me for information OK Thank you! An ArtWeek team member will reach out directly via email in 2 - 4 weeks to follow up with you to confirm your participation and collect some additional information. OK DONE