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ABOUT YOU

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* 1. First and Last Name

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* 2. Pronouns
This helps us understand the correct way to address you. Select all that apply.

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* 3. Agency Name
If you're not associated with an agency, please provide the name of your art program.

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* 4. Your Position / Title

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* 5. Primary Email Address

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* 6. Primary Email Address Type

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* 7. I'd like to add a secondary email address

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* 8. Secondary Email Address

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* 9. Secondary Email Address Type

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* 10. Phone Number

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* 11. Phone Number Type

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* 12. Primary Mailing Address (for mailing raffle prizes, incentives, and important announcements)

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* 13. My agency address is the same as my primary mailing address above.

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* 14. Agency Address

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* 15. What are your academic credentials (if applicable)? (e.g., LCSW, MFT, MA Ed., etc.)

WHERE YOU WORK

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* 17. In which settings do you conduct art workshops? Select all that apply.

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* 18. Do you offer art workshops outside of the United States?

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* 19. If you answered "Yes" to question 13, please share which countries.

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* 20. What percentage of your art workshops are one-on-one?

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* 21. What percentage of your art workshops are with groups?

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* 22. Do you or your organization use participant artwork to communicate with community stakeholders and donors?

YOUR INDIVIDUAL YEARLY REACH

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* 23. Please provide the estimated total number of unduplicated individuals you personally served through AWBW workshops this year. Count each participant only once. Please include fellow staff, family, and friends you facilitated with.

Annual estimated unique individuals served:

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* 24. From participants reported above, what percentage consists of families of two or more individuals? Family relationships can include parents, children, siblings, grandparents, aunts, uncles, and more.

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* 25. What is the primary age group you serve through art workshops? Select one.

HOW DOES ART HELP?
Please rate the impact of art workshops based on your personal observations of participants’ experience this year.

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* 32. Would you or your organization have an art program without the support of AWBW?

YOUR ART WORKSHOP PARTICIPANTS

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* 33. What are the life experiences of those you serve through art workshops? Select all that apply.

What percentage of your participants are from the following ethnic backgrounds? Your total allocation across all ethnic backgrounds should add up to 100%. Please use your best estimations. 

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* 34. What percentage of your participants are Alaskan Native?

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* 35. What percentage of your participants are American Indian or Native American?

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* 36. What percentage of your participants are Asian?

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* 37. What percentage of your participants are Black or African American?

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* 38. What percentage of your participants are Latinx?

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* 39. What percentage of your participants are Middle Eastern?

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* 40. What percentage of your participants are multi-racial?

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* 41. What percentage of your participants are Native Hawaiian or other Pacific Islander?

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* 42. What percentage of your participants are White?

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* 43. What percentage of your participants are of an ethnicity not listed above?

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* 44. For participants whose ethnic identities are not listed above, please specify their ethnicities below.

What are the gender identities of your participants? Your total allocation across all gender identities should add up to 100%. Please use your best estimations. 

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* 45. What percentage of your participants identify as female?

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* 46. What percentage of your participants identify as male?

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* 47. What percentage of your participants identify as non-binary?

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* 48. What percentage of your participants identify as transgender?

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* 49. What percentage of your participants have a gender identity not listed above?

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* 50. For participants whose gender identities are not listed above, please specify how they identify below.

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* 51. What percentage of your participants are at or below the Federal Poverty Line?
Website: 2024 Federal Poverty Level Guidelines

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PROFESSIONAL & PERSONAL IMPACT

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* 52. How would you rate the impact of our program in bringing about positive change in your personal life?

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* 53. How would you rate the impact of our program in bringing about positive change in your professional life?

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* 54. Please select all the ways our program has brought about positive change in your personal and professional life.

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* 55. Can you share specific examples of how our program has positively impacted your life, both personally and/or professionally? Please elaborate on any significant changes, skills gained, or challenges overcome.

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* 56. How would you rate the level of stress and burnout in your life?

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* 57. How likely are you to recommend the Windows program and our two-day training to someone you know?

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* 58. Simply spreading the word about AWBW's trainings and resources can make an impact. Would you like to join our Training & Outreach Team to help share about our upcoming trainings?

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* 59. Do you know of any individuals or organizations that might be interested in joining our community of art facilitators? If so, please provide their names, email addresses, and any relevant website information.

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* 60. Please share one word that sums up your experience with art facilitation in 2024.

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* 61. Anything else you'd like to share with us?

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