POET LAUREATE PROGRAM APPLICATION

Poet Information

The role of the Poet Laureate is to represent and promote poetry and literacy in Costa Mesa. This position is honorary and includes an honorarium in the amount of $5,000 (two payments of $2,500), for a two-year term, which commences on September 2, 2024 and concludes on September 2, 2026.

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* 1. Contact Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Website URL (if applicable):

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* 3. Facebook URL (if applicable):

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* 4. Instagram URL (if applicable):

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* 5. Will you be over the age of 18 before September 2, 2024?

Yes

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* 6. Please provide a statement of no more than 500 words explaining how you qualify and how you would fulfill this role:

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* 7. Please provide a short biography (required). You may also attach a CV with education, work history, etc. below (optional):

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* 8. Original Poems:

Email or upload one document (Word or PDF) with 5 original poems- please include the title of each poem, the year it was created and a brief background/statement for each one

PDF, DOC, DOCX file types only.

Choose File

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* 9. Videos of Performances:

Please provide a link to a performance video posted online or to a shared drive

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* 10. Attach a Curriculum Vitae (CV) or Resume (optional):

Please email or upload a copy of your most current resume of CV (Word or PDF) Include any literary works published in journals, online, a full-length or chapbook collection of poetry, or self-published chap/books; or have a list of spoken word performances or facilitation of writing related events. Also be sure to include any examples of community engagement and collaboration, including previous experience hosting events, organizing, teaching and/or leading workshops, and/or creative community outreach.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 11. A Poet Laureate honorarium in the amount of $5,000 will be awarded over a two-year period (two installments of $2,500). Checks will be mailed. In order to payout, the City will need a W-9 filed. Fill out and upload as part of your application.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 12. Would you be interested in participating in a brief interview for City of Costa Mesa social media platforms to help promote and bring awareness to the program?

Yes

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* 13. Please acknowledge the statements below by clicking each box and signing and dating below.

I have read and understand the requirements that have been provided in the handbook for the Poet Laureate Program.

Waiver & Release: I certify that the information contained in this application and attachments are true and correct.

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* 14. I represent that I am the author of and owner of all rights in and to the Artwork and that I have the sole and exclusive right to make within the grant of rights, including but not limited to moral rights, that neither I nor anyone else has any contractual or other arrangements which will interfere with rights herein granted and warrant that the rights herein granted will not infringe on the rights of any third party and that the consent or permission of no other party is required by City in connection with the use of the Artwork. I agree to indemnify and hold City harmless from and against any and all liability, damages, claims and demands of whatever kind and nature, either in law or in equity, which arises or may hereafter arise from the City's use or display of the Artwork or in connection with the breach or alleged breach of my representation and/or warranty made hereunder. I understand and agree that the City may remove my artwork at any time without prior notice. I further acknowledge the City will make an effort to inform me as the artist in advance of the removal of the artwork, but any such removal will not be dependent on advance notice being given.

I agree to the above statement by signing/typing my name:

Date:

POET LAUREATE PROGRAM APPLICATION

Poet Information

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* 1. Contact Information

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* 2. Website URL (if applicable):

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* 3. Facebook URL (if applicable):

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* 4. Instagram URL (if applicable):

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* 5. Will you be over the age of 18 before September 2, 2024?

Question Title

* 6. Please provide a statement of no more than 500 words explaining how you qualify and how you would fulfill this role:

Question Title

* 7. Please provide a short biography (required). You may also attach a CV with education, work history, etc. below (optional):

Question Title

* 8. Original Poems:

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* 9. Videos of Performances:Please provide a link to a performance video posted online or to a shared drive

Question Title

* 10. Attach a Curriculum Vitae (CV) or Resume (optional):

Question Title

* 11. A Poet Laureate honorarium in the amount of $5,000 will be awarded over a two-year period (two installments of $2,500). Checks will be mailed. In order to payout, the City will need a W-9 filed. Fill out and upload as part of your application.

Question Title

* 12. Would you be interested in participating in a brief interview for City of Costa Mesa social media platforms to help promote and bring awareness to the program?

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* 13. Please acknowledge the statements below by clicking each box and signing and dating below.

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* 9. Videos of Performances:

Please provide a link to a performance video posted online or to a shared drive