Artist in Residence Application Form 2022

The Grace Butler Memorial Foundation Award at Ara

Personal Details

First Name:

Last Name:

Address:

City:

Postcode:

Work:

Home:

Mobile:

Email:

Password:

Declaration:

I agree to the Terms and Conditions and the following declaration:

I am a New Zealand citizen
I am pleased to undertake this residency in Canterbury for the prescribed period of three months, the dates of the residency to be negotiated in consultation with the Grace Butler Memorial Foundation.
All information provided in my application to the Grace Butler Memorial Foundation is correct.
I consent to the disclosure of any information from the referees or any other person to the selection committee relating to this application.
The photographs are of my own work.