2020 Merrigong & Performing Lines Digital Artist Residency - Expression of Interest

ABOUT YOU

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1. Name (Required.)

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2. Date of Birth (Required.)

Date

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3. Gender (Required.)

Female

Male

Other (Optional)

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4. Address (Required.)

Address

City/Town

State/Province

ZIP/Postal Code

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5. Email (Required.)

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6. Mobile Phone (Required.)

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7. Are you applying to attend as an individual or as a group? (Required.)

Individual

Group

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8. If applying as a Group - Group Member(s) Details - please include name and email address for each additional group member you would like to attend, up to a maximum of 3 members in total. NOTE: extra members may be required to contribute a higher amount toward the cost of attending.

Group Member 1

Group Member 2

Group Member 3

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9. Do you (or someone in your group) identify as a person with disability? (Required.)

Yes

If YES: Name (if not primary applicant)

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10. Do you (or someone in your group) identify as a person from a culturally and linguistically diverse background? (Required.)

Yes

If YES: Name (if not primary applicant)

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11. Do you (or someone in your group) identify as an aboriginal and/or torres strait islander? (Required.)

Yes

If YES: Name (if not primary applicant)

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12. Please provide a short arts biography for yourself / each member of the group (Max 150 words per person - any more than this will be cut off when shared with selection panel) (Required.)

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13. If your expression of interest is successful you will need to be available for the whole 3 days of the residency
Friday 16 October – full day, with optional evening sessions
Saturday 17 October - full day, with optional evening sessions
Saturday 31 October – full day (Required.)

Yes I can confirm my/our availability for those dates and times

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14. Whilst the residency is heavily subsidised, each successful applicant will be required to pay a deposit of $100 to secure their spot of which $75 is fully refundable after attendance at the residency and completion of the debrief survey. Instalment plans can be discussed for those experiencing financial difficulty.
NOTE: Where a group is successful each member will be required to pay the full deposit to secure their spot. (Required.)

I/we agree to providing a deposit of $100 (each) if successful

I/we are experiencing financial difficulty and would like to discuss alternative arrangements

2020 Merrigong & Performing Lines Digital Artist Residency - Expression of Interest

ABOUT YOU

Question Title

* 1. Name (Required.)

Question Title

* 2. Date of Birth (Required.)

Question Title

* 3. Gender (Required.)

Question Title

* 4. Address (Required.)

Question Title

* 5. Email (Required.)

Question Title

* 6. Mobile Phone (Required.)

Question Title

* 7. Are you applying to attend as an individual or as a group? (Required.)

Question Title

* 8. If applying as a Group - Group Member(s) Details - please include name and email address for each additional group member you would like to attend, up to a maximum of 3 members in total. NOTE: extra members may be required to contribute a higher amount toward the cost of attending.

Question Title

* 9. Do you (or someone in your group) identify as a person with disability? (Required.)

Question Title

* 10. Do you (or someone in your group) identify as a person from a culturally and linguistically diverse background? (Required.)

Question Title

* 11. Do you (or someone in your group) identify as an aboriginal and/or torres strait islander? (Required.)

Question Title

* 12. Please provide a short arts biography for yourself / each member of the group (Max 150 words per person - any more than this will be cut off when shared with selection panel) (Required.)

Question Title

* 13. If your expression of interest is successful you will need to be available for the whole 3 days of the residency Friday 16 October – full day, with optional evening sessions Saturday 17 October - full day, with optional evening sessions Saturday 31 October – full day (Required.)

Question Title

1. Name (Required.)

2. Date of Birth (Required.)

3. Gender (Required.)

4. Address (Required.)

5. Email (Required.)

6. Mobile Phone (Required.)

7. Are you applying to attend as an individual or as a group? (Required.)

8. If applying as a Group - Group Member(s) Details - please include name and email address for each additional group member you would like to attend, up to a maximum of 3 members in total. NOTE: extra members may be required to contribute a higher amount toward the cost of attending.

9. Do you (or someone in your group) identify as a person with disability? (Required.)

10. Do you (or someone in your group) identify as a person from a culturally and linguistically diverse background? (Required.)

11. Do you (or someone in your group) identify as an aboriginal and/or torres strait islander? (Required.)

12. Please provide a short arts biography for yourself / each member of the group (Max 150 words per person - any more than this will be cut off when shared with selection panel) (Required.)

13. If your expression of interest is successful you will need to be available for the whole 3 days of the residency
Friday 16 October – full day, with optional evening sessions
Saturday 17 October - full day, with optional evening sessions
Saturday 31 October – full day (Required.)