Questionnaire on Theater Workshops
Name	Date & Place of Birth dd-mm-yyyy
Sex            Gender Female Male	Place of Residence
Education	Artistic Field
Practical Experience
Mailing Address
Phone	Fax
Email
Are you a member of an artistic group or organization?
Yes/No	If so, name it
Mailing Address
Phone	Fax
Email
In your opinion, what are the needs of your country in terms of theater, art, and technical skills? And why?
I would like to participate in the following workshop:
Acting Lighting Sound Writing Music
Dance Costume Make-up Production Puppets & Masks
Others
Why?
Suggested duration of the workshop 3-5 days 1 week 2 weeks 1 month or more
Notes and Suggestions
How did you receive this form?
Date dd-mm-yyyy	Signature