NC Museum of History/NC African American Heritage Commission
African American Cultural Celebration Presenter Application
Please Note: If under 18 years of age, a parent or guardian must complete and sign this form.
Last Name
First Name
Middle Name or Initial
Address (Street Number and Name)
City
State
Email
Home Phone (include area code)
Cell Phone
Type of presentation:
 Music
 Dance
 Historical Topic
 Drama
 Author
 Spoken Word
Gender:
 Storytelling

 Film
 Artist/Craftsperson  Male
 Female
 Business
 Health/Wellness
 Foodways/Cooking
 Other
Connection to NC
Zip
Title of Presentation
(if applicable)
Short Description of Presentation:
Education/Relevant Experience:
Website, Blog, MP3 file or other Internet site
(if applicable)
Reference 1
Name: _______________________________
Reference 2
Name: _______________________________
Reference 3
Name: _______________________________
Address: _____________________________
Address: _____________________________
Address: _____________________________
City: ________________________________
City: ________________________________
City: ________________________________
State: __________
State: __________
State: __________
Zip: _______________
Zip: _______________
Zip: _______________
Email: _______________________________
Email: _______________________________
Email: _______________________________
Phone: _______________________________
Phone: _______________________________
Phone: _______________________________
Note: You must provide a minimum of three (3) references (including their name, address, telephone number, email address, etc.)
Please send a resume or answer the questions listed below to assist the selection committee.
1.List brief description of the areas in which you have experience. (music, dance, drama, art, etc.)
2. List events in which you have performed or exhibited on the back of this sheet. Attach additional sheets if necessary. Please include
copies of any literature or articles that included your performance, website, photographs or any additional information that might be
helpful to the selection committee.
This form will be used by the NCAAHC and the NCMOH to vet potential presenters for the African American Cultural Celebration.
 I hereby authorize the NC African American Heritage Commission and/or the NC Museum of History to publish my information in an Artist Directory.
 I do not wish to be listed in the Directory, but would like to be considered for any events sponsored by the NCMOH or NCAAHC.
Signature of Applicant (unsigned forms will not be included) ___________________________________________________________
Date ________________________
Parent/Guardian Signature Required if applicant is under 18 years old. ____________________________________________________
Date ________________________
Please return form to: Emily Grant, NC Museum of History, 5 E. Edenton St.Raleigh, NC 27601, Emily.grant@ncdcr.gov,
919.807.7979, FAX:919.733.8766
March 2015
Selection Criteria
A selection committee made up of museum staff, members of the African American Heritage Commission,
scholars, artists, authors, musicians, community organizers, and business members reviews applications for
presenters for the African American Cultural Celebration.
While the selection committee is open to presenters from across the country, priority is given to presenters who
currently live in and serve North Carolina communities and/or whose presentations have a strong connection to
North Carolina history and culture.
Other criteria/considerations of the committee are to create a slate of presentations that:
1.
2.
3.
4.
5.
6.
represent a balance of geographical regions in the state (mountain, piedmont, and coastal regions)
show a balance of different time periods
have a variety of topics/types of presentations
show a strong relationship to the theme
demonstrate clear ways of engaging the audience or include visitor participation
support both emerging performers/presenters as well as experienced/well known professionals
Note: Additional criteria may apply depending on the category of presentation. (ex: literature and the spoken
word may have criteria such as “having a balance of children’s authors, historical/non-fiction, and fiction”)
All applications must be received by September 1, 2015.
Applicants will be notified of selection by December 1, 2015.
In the event that your application is not in the initial selection of presenters, but an opening becomes available
closer to the event date, would you consider being put on a waiting list?  Yes
 No