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Artistic Group Recognition

Name of group

Contact person and their mailing address

City

Province

Postal Code

Phone Number

Form submitted by

Email and Phone of person submitting the form

RECOGNITION FOR COMPETITION - AWARDS RECEIVED:

Won 1st prize, placed second or third in a regional, provincial, national or international competition for their art (literature, dance, drama, visual arts, music etc). If submitting more than one competition/achievement, please provide all of the requested information on back page for each award to be recognized.

Name of competition

Competition level (regional, provincial, etc.)

Date of event

Location of competition (city, province/state)

Award received or level placed (1st, 2nd, ord 3rd)

Categeory

Name of competition's organizing body

Competition contact name (for verification)

Phone number or email address

RECOGNITION FOR NATIONAL ACCLAIM:

For groups who have been recognized for their art through national acclaim, scholarship or acceptance to an accredited national school. If submitting more htan one achievement, please provide all the the requestd information on separate pages for each acclaim to be recognized.

Type of acclaim

Additional information/comments (attach if necessary)

Additional items as backup

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

If you are mailing your form, please mail to:

Recreation Coordinator
c/o the Cambridge Centre for the Arts
60 Dickson Street
Cambridge, ON N1R 8N1

Telephone: (519) 740-4681 ext. 4565

Deadline: August 31

Group members information

Group member #1 full name

Group member's address

City

Province/state

Postal code

Phone

Group member #2

Group member's address

City

Province/state

Postal code

Telephone

Group member #3 full name

Group member's address

City

Province/state

Postal code

Telephone

Group member #4 full name

Group member's address

City

Province/state

Postal code

Telephone

Group member #5 full name

Group member's address

City

Province/state

Postal code

Telephone

Group member #6 full name

Group member's address

City

Province/state

Postal code

Telephone

Personal information in relation to this process is collected under the authority outlined in the Municipal Freedom of Information and Protection of Privacy Act. This information will be used only for the purpose for which it is intended. If you have any questions regarding this collection of personal information, you can contact the Freedom of Information and Privacy Coordinator, who can be reached through the Clerk’s Office at (519) 740-4680. Ext 4583.