AIR 2018 Application Form

APPLICATION DEADLINE: 15 October 2018
1. RESIDENCY APPLYING FOR:*
Please indicate which Artists in Residency programme/s you are applying for. You are permitted to apply for as many of the residencies as you wish but we recommend that you only select the spaces for which you are best suited.
- Bundanon Trust – Australia
- The Fountainhead Residency – USA
- International Studio & Curation Program - USA
- Instituto Sacatar – Brazil
Please carefully read through the Application Guidelines for more details about each residency and ensure that the residency you are applying for caters to your artistic discipline.
2. APPLICANT DETAILS:
Full Name (Last Name, First Name, Middle Name):*
Country of Birth:*
Date of Birth (mm/dd/yyyy)*
MM slash DD slash YYYY
Gender:
- Female
- Male
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Country You Currently Reside In:*
Landline number

Please enter your landline number. Please make sure to add the country code. e.g +27 021 555 5555
Mobile number*

Please enter your mobile number. Please make sure to add the country code. e.g +27 082 555 5555
E-mail address:*
Which language/s do you speak:*

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APPLICATION DEADLINE: 15 October 2018