NYA Judge Application ~ Contact Information ~ First Name: Last Name: Your E-mail: Address: City: State: ZIP: Mailing Address (if different): City: State: ZIP: Contact Phone: Company Phone (if different): ~ Questionnaire ~ In which field(s) of the arts are you interested in judging? Theatre Dance Music Film Writing Photography Painting Fashion Why do you want to be a judge? If judging Theatre, Dance, or Music, are you willing to see at least five events spread out amongst a minimum of three different venues annually? Yes No Are you interested in writing reviews of some events you judge? Yes No Are you or a family member currently any of the following (if so, please describe in box below): Employed by a youth arts organization, company, or school program Board member of a youth arts organization An artist working in the arts Statement of qualifications, experience, and/or involvement in the arts: Biographical Blurb: ~ Conflict of Interest Statement ~ Because the National Youth Arts Awards Judges are very interested in theatre and often are professionally involved in the arts, it is important they be constantly aware of possible conflicts of interest. Potential judges should not disqualify themselves from participation in realted arts, arts organizations or in arts projects because of their involvement as a judge. Such experience makes for a more valued adjudicator. But regardless of whether judges are associated with a specific group or arts organization, he/she is expected to serve as an unbiased National Youth Arts Award representative. Therefore, judges should be alert to avoid any action that could possibly be interpreted as influencing theatres to further their own interests or those of an organization, or artist with which they are affiliated or which they instruct. Therefore, judges should not evaluate any production at a theatre or organization with which they are currently affiliated as a paid or volunteer board member, instructor, staff member, designer, performer, artist, or employee; and should not evaluate any specific production for which they sought employment, either through application or audition, or in which members of their immediate family are involved. Please list in the box below all theatres for which you should not judge due to a real or perceived conflict of interest as known at the time of your application: ~ Signature ~ I have read and understand the Judge Requirements and agree to follow these requirements if selected as a judge. Signature: Date: