APPLICATION FOR MEMBERSHIP

APPLICATION FOR MEMBERSHIP

Daylesford Regional Arts Co-operative
MEMBERSHIP IS RESTRICTED TO RESIDENTS OF THE HEPBURN SHIRE
Do you currently reside in the Hepburn Shire?*

Yes
Name*

First NameLast Name
Date of birth*

DayMonthYear
Address*

Street Address

Street Address Line 2

CityState

Post Code
Email*
example@example.com
Phone Number*

Area Code or Mobile PrefixPhone Number
Please indicate your medium/media of choice*

PrintmakingPaintingPhotographyTextilesCeramicsOther
How did you hear about DRAC?
Your bio*

0/100
Upload your artist profile image*

Image must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Do you have any special skills you could contribute to DRAC?

0/100
Are you a member of other Arts based organisations?*

YesNo
If you answered Yes to the above question, please list organisations.
Please list any exhibitions, shows and events you have been part of in the last 12 months.
You must upload details of at least three artworks

but you can upload as many as eight.
Upload artwork 1 image*

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 1 title*
Artwork 1 media*
Is artwork 1 framed?*

YesNo
Artwork 1 width in cms*
Including frame if applicable
Artwork 1 height in cms*
Including frame if applicable
Upload artwork 2 image*

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 2 title*
Artwork 2 media*
Is artwork 2 framed?*

YesNo
Artwork 2 width in cms*
Including frame if applicable
Artwork 2 height in cms*
Including frame if applicable
Upload artwork 3 image*

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 3 title*
Artwork 3 media*
Is artwork 3 framed?*

YesNo
Artwork 3 width in cms*
Including frame if applicable
Artwork 3 height in cms*
Including frame if applicable
Upload artwork 4 image

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 4 title
Artwork 4 media
Is artwork 4 framed?

YesNo
Artwork 4 width in cms
Including frame if applicable
Artwork 4 height in cms
Including frame if applicable
Upload artwork 5 image

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 5 title
Artwork 5 media
Is artwork 5 framed?

YesNo
Artwork 5 width in cms
Including frame if applicable
Artwork 5 height in cms
Including frame if applicable
Upload artwork 6 image

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 6 title
Artwork 6 media
Is artwork 6 framed?

YesNo
Artwork 6 width in cms
Including frame if applicable
Artwork 6 height in cms
Including frame if applicable
Upload artwork 7 image

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 7 title
Artwork 7 media
Is artwork 7 framed?

YesNo
Artwork 7 width in cms
Including frame if applicable
Artwork 7 height in cms
Including frame if applicable
Upload artwork 8 image

Images must be at least 1000 px on long side @ 72 dpi. Max file size 3 MB. File types jpg, jpeg, png
Cancelof
Artwork 8 title
Artwork 8 media
Is artwork 8 framed?

YesNo
Artwork 8 width in cms
Including frame if applicable
Artwork 8 height in cms
Including frame if applicable
Your website URL
This will be displayed in your member profile
Your Facebook username
This will be displayed in your member profile
Your Instagram username
This will be displayed in your member profile
Other social media username
If supported, this will be displayed in your member profile
Declaration*

I have read and understand the Membership Guidelines
Please verify that you are human*
Should be Empty: