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COMPLETE application must be submitted by April 18th, 2008 |
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Personal Information |
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First Name |
Last Name |
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Phone number ( ) |
Fax number (
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Street Address |
City |
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Country |
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State/Province |
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Zip/Postal Code |
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Contact preference: Email
* Phone
* Fax
* |
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The following must be submitted to assure consideration for the
residency |
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10 slides of your Current work included
*YES
*NO |
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Be sure to include a brief biography & artists statement |
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Non Refundable application fee of $15.75 (including GST) |
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Payment Method
*Visa *Master Card
*Personal Cheque made out to: (Medalta International Artist
In Residence) |
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Is the deposit included *YES
*NO |
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Card Number: |
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FEES: All Fees are Calculated in Canadian Funds |
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Non-Refundable Application Fee |
$15.75including tax |
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Total due upon acceptance of this application |
$540.75 including tax |
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Have you included all required information with this application
*YES
*NO |
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Did you submit a letter of intent including an indication your working
preference e.g. wheel, hand building sculpture,*YES*NO |
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Mail your Completed application to: |
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Medalta International
Artist In Residence |
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713 Medalta Ave, SE, Medicine Hat , Alberta |
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Are you excited about participating in one of the most rewarding and fulfilling
experiences of your life
R YES |
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