Please complete this form to register for the Kennesaw Artists Network (KAN).
No information will be posted to the online directory without your consent. There is no fee for joining the online directory.

Name:

Home Address:

City:

State:

Zip Code:

Home Phone:

Business:

Business Address:

City:

State:

Zip Code:

Business Phone:

Preferred E-mail:

Your Home Page URL:


Which address do you prefer to have listed in the directory?
Home
Business
Neither

Which phone number do you prefer to have listed?
Home
Business
Neither

May we list your e-mail address?
Yes
No

Do you want us to provide a link to your URL?
Yes
No

If you would like to include a photo in the KAN online directory, please e-mail it to arts@kennesaw.edu.


Are you: (check all that apply)
A graduate of Kennesaw State University?
A current student of Kennesaw State University?
A current or former KSU faculty or staff member?
The spouse or partner of an alumnus, student, faculty member or staff member?
A relative of an alumnus, student, faculty member or staff member?
Someone else entirely?
Please specify:

EDUCATION
May the information in this section be included in the online directory?
Yes No

Please indicate your major, if you are a graduate or current student. (Check all that apply.)
Art Education
Music
Music education
Music performance
Studio art
Theatre
Other, please specify:


Year of graduation, if applicable.

Degree earned from KSU: (Check all that apply.)
AA
BA
BFA
BM
BS
AS


Please list any other degrees you have earned or are working to complete:
Degree #2: Field: Year of Completion:

Institution:

Degree #3: Field: Year of Completion:

Institution:

Degree #4: Field: Year of Completion:

Institution:

CAREER
May the information in this section be included in the online directory?
Yes No

Current occupation and/or active hobbies in the arts: (Check any and all that apply.)

Theatre fields:
Actor
Director
Theatre teacher
Acting coach
Scenic designer/artist
Theatre tech
Playwright
Screenwriter
Costume Designer
Artist manager
Booking agent
Make-Up Artist
Dramaturg/Literary Director
Dancer
Choreographer
Model
Production manager
Technical director
Producer
Puppeteer
Stage manager
Storyteller
Performance artist
Sound designer
Light designer

Music fields:
Performer
Music educator (in a school or program)
Music teacher (private studio)
Composer
Music technology
Conductor
Director
Music historian
Music engineer
Music producer

Visual arts fields:
Studio artist
Art educator (in a school or program)
Art teacher (private studio)
Graphic artist/designer
Web designer
Lettering Artist/Callligrapher
Scenic designer
Gallery manager
Gallery owner
Museum director
Curator
Art historian
Interior designer
Landscape designer
Photographer

Other fields — Please specify:

Current occupation outside of the arts:
Please specify:

You may provide a brief career summary. Only the first 150 words can be included in the online directory.

PERSONAL
May the information in this section be included in the online directory?
Yes No

Birthday:
Name of spouse/domestic partner:
Birthday of spouse/domestic partner:

Children:
Name:    Age:
Name:    Age:
Name:    Age:

Additional hobbies or interests not indicated above. Limit 20 words.


You may provide a brief bio of your spouse/domestic partner. Only the first 150 words can be included in the online directory.

GOALS
The information in this section will not be included in the online directory.

Would you be interested in serving as an organizer for the local KAN group?
Yes
No

Would you be interested in serving as an organizer for the national KAN?
Yes
No

Would you like to receive the College of the Arts’ weekly e-mail newsletter?
Yes
No

Would you like to receive the College of the Arts’ magazine, Flourish, published twice a year?
Yes
No

Would you like to be included in the mailing list for the KSU Alumni Association?
Yes
No

You may briefly outline any goals that you think may be of interest to fellow KAN members. Limit 100 words.

SURVEY
The information in this section is intended to help build the Kennesaw Artists Network.
It will not be included in the online directory.

Please check any of the activities/resources you think KAN should provide:
Workshops/Training
Professional Conferences
Group Travel Planning
Reunions
Artist-in-Residence Programs at KSU
Online Bulletin Board
Weblog
Listserv
Events with current and former faculty members
Alumni Awards
Social Activities
Networking Activities
Newsletter
Discounts for KSU Arts Events
Other — Please specify: