SURVEY - IMPACT OF WOOLSEY FIRE ON ARTISTS
RequiredRequired Question(s)
Dear Artist,
We are reaching out to all local artists to see who has been impacted by the Woolsey Fire.  Did you lose your art supplies?  Did you lose past works that you created?  Are you able to create? 
Please answer the following survey so we can move forward with any possible assistance.
 
Required 1.
To participate, please enter the information indicated below.

First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com

Required 2.
WHAT IS YOUR ARTISTIC MEDIUM? (example:  paint on canvas, music, sculpture, etc.)
 

350 characters left.
Required 3.
DID YOU LOSE YOUR SUPPLIES IN THE FIRE?
Yes
No
Some items were lost
Other  
  • Comment:

  • 500 characters left.
Required 4.
May we give your contact information to a local partner interested in giving financial assistance to artists impacted by the Woolsey Fire?
YES
NO
Other  
  • Comment:

  • 500 characters left.
This Survey is intended to understand the impact of the Woolsey Fire on artists.  We would like to know how you have been impacted and what you need help with in order to be able to create.  There is no solicitation involved.