Mountain View Artist Residency Application Form
Personal Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
I will be bringing a guest (18+ over only). Please note an additional $25/night will be added to your stay.
*
Yes
No
I will be bringing a service animal
*
Yes
No
How did you hear about this residency?
Residency Information
Preferred length of stay
*
3 Days (No Weekends)
5 Days (Sunday - Friday)
10 Days (Sunday - Wednesday)
Other
My preferred residency period (eg: Oct 4-Oct 6). Please ensure you select a date range a minimum of 30 days from the date of your application.
*
1st Choice
*
2nd Choice
Introduce yourself and your creative practice
Add your proposal statement here. A 250-500 word statement that outlines what you hope to achieve during your residency.
Paste your CV detailing your professional practice
Support Materials
Browse Files
Drag and drop files here
Choose a file
1 image or writing sample (.jpg, .pdf, .doc format)
Cancel
of
By checking this box, I acknowledge have read and understand the residency program information and to the best of my knowledge the information I have supplied is true and accurate.
*
I Agree
By checking this box, I acknowledge that this residency is for adults only and I will not be bringing any guests under 18 years of age.
*
I Agree
Please verify that you are human
*
Submit
Should be Empty: