the application

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CHM TEEN SUMMER RESIDENCY: CLICK, TAG, SHARE | APPLICATION
Applications are being accepted from teens in the Chicagoland area who would like to participate in a
summer residency exploring documentary photography at the Chicago History Museum.
• Applications must include a nomination from a teacher, group leader, or other adult advocate.
• Selected participants should be able to attend weekly meetings at the Museum starting the last full
week of June and continuing through the first week of August (indicate availability in Step 4 of
application).
• Selected participants must supply their own image-taking device, whether a cell phone, iPad, or
camera.
• Ventra cards will be provided for transportation to and from the Museum.
• This program is FREE to selected teens.
Return your completed application by Monday, May 18, 2015 through one of the following options:
• Email: Educator@chicagohistory.org
• Mail: Chicago History Museum, Education Department, 1601 N. Clark Street, Chicago, IL 60614
• Fax: 312-799-2458
Questions? Email Educator@chicagohistory.org
Step 1) To be completed by nominating teacher, group leader, or other adult advocate
Nominator’s Name _________________________________________________________________
Nominator’s Email Address __________________________________________________________
Nominator’s Phone Number __________________________________________________________
Step 2) To be completed by nominating teacher, group leader, or other adult advocate
Please type or clearly print your response in the space below. You may attach additional paper if necessary.
Why do you think the teen you are nominating would be a good fit for the Chicago History Museum’s
Teen Summer Residency and how would he/she benefit from the program?
How have you seen him/her demonstrate commitment to a project, reliability, and follow-through?
Step 3: To be completed by the teen applicant and his/her guardian
Teen’s Name _____________________________________________________________________
Teen’s Email Address ______________________________________________________________
Teen’s Phone Number ______________________________________________________________
Guardian’s Name __________________________________________________________________
Guardian’s Phone Number ___________________________________________________________
Step 4) To be completed by teen applicant
Please type or clearly print your response in the space below. You may attach additional paper if necessary.
Why you are interested in CHM’s Teen Summer Residency and what do you hope to gain from it?
Describe a project, assignment, or experience that demonstrates your creativity and/or interest in
capturing the world around you. You may choose to include examples of your work.
What type of camera or image capturing device (phone, iPad, etc.) do you plan to use?
Please circle ALL of the times during which you are available to meet weekly starting the last full
week of June through the first week of August.
Tuesdays:
11am-2 pm
2-5pm
4-7pm
Thursdays:
11am-2 pm
2-5pm
4-7pm