Griffis Art Center - International Artist-in-Residence Program

THE GRIFFIS ART CENTER


INTERNATIONAL ARTIST-in-RESIDENCE PROGRAM
APPLICATION

INTERNATIONAL ARTIST-in-RESIDENCE PROGRAM GUIDELINES
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18 BRISTOL STREET / NEW LONDON, CONNECTICUT 06320 USA
PHONE: (860) 447-3431 FAX: (860) 444-7547 E-MAIL:director@griffisartcenter.com

Please answer all questions and return this application and all other applicable materials to the above address.
Please type or print clearly.



Date: Name: Present address and telephone number: Other names (show all other past and present names, including maiden name if married): Present nationality or citizenship: Date and place of birth: Name of sponsor of referral (if any): Name, address, telephone number and relationship of a family contact in case of emergency:
PLEASE INCLUDE INFORMATION ABOUT THE FOLLOWING:

  EMPLOYMENT HISTORY

On a separate piece of paper please list your work history for the past ten years.
Include dates of employment and name and location of company.

  EDUCATIONAL & ART BACKGROUND

On a separate piece of paper please list your formal education, dates, schools attended and degrees earned.
Please also list any exhibits participated in and/or awards received.

  PERSONAL ARTIST STATEMENTS

On a separate piece of paper, please answer the following:
1. Describe both yourself and your art work. For example what you would like to accomplish personally, or what you would like
your art work to convey.
2. Why do you want to participate in the Griffis Art Center's Artist-in-Residence Program?
3. What do you hope to accomplish at the Griffis Art Center?

LETTERS of RECOMMENDATION

Include two (2) letters of recommendation.
The Griffis Art Center desires information about your character, personality, ability and capacity for independent work.
We shall be grateful for a full and frank statement, indicating any firsthand opportunities your reference has about you and your work.
Also include your strengths and limitations.

MEDICAL BACKGROUND

Do you have high blood pressure?Yes No

Do you smoke?Yes No

Do you have an alcohol or drug addiction problem?Yes No If Yes, please explain.

List any medications you are presently taking:

Are you allergic to any medications or food? Yes No If yes, please list.

Have you suffered any major physical or emotional illness in the past five years? Yes No If yes, please explain.

Do you carry personal medical or dental insurance? Yes No If yes, please list.

Have you had major dental work in the last five years? Yes No If yes, please explain.
THIS SECTION TO BE COMPLETED BY PERSONS OTHER THAN UNITED STATES CITIZENS

Has an Immigrant Visa Petition or Application for Permanent Labor Certification ever been filed in your behalf?
Yes No If yes, please explain.

Have you ever applied for an Immigrant Visa or permanent residence in the United States?
Yes No If yes, where did you apply?

To your knowledge, has any Visa Petition filed by you or any other organization been denied?
Yes No If yes, list date of filing of each petition and the city of each filing.

Have you been to the United States before? Yes No If yes, when and for how long?

Proposed port of entry to the United States:

Proposed port of exit from native country:

Address of American Consulate at which you will apply for your visa:

Passport #: ____________________________
Visa: _________________________________ Expires:____________________________

A COMPLETE APPLICATION INCLUDES THE FOLLOWING:


I have read The Griffis Art Center, International Artist-in-Residence Program Guidelines and agree, if selected, to abide by all items listed therein.


Artist's Signature: ___________________________________________ Date: _______________________________

INTERNATIONAL ARTIST-in-RESIDENCE PROGRAM GUIDELINES
RETURN to ARTIST-in-RESIDENCE PROGRAMS MAIN MENU | RETURN to GAC MAIN MENU