Artist Membership Application

Please fill out the following form with as much information as you can provide, then click the submit button to send it to A.N.E.W.

 

Last Name:


First Name:


Street Address:


City: State/Provence: Zip:


Country:


Phone:

Fax:

E-mail:

URL:



Please indicate your primary discipline(s): (Click all that apply.)

Fine Arts: Painting
Fine Arts: Sculpture
Fine Arts: Mixed Media
Fine Arts: Photography
Fine Arts: Video
Fine Arts: Film
Fine Arts: Multimedia
Fine Arts: Installation
Fine Arts: Performance
Music: Classical
Music: Jazz
Music: Pop
Music: Alternative
Music: Experimental
Music: Composer
Dance: Ballet
Dance: Modern
Dance: Choreographer
Writer: Poetry
Writer: Fiction
Writer: Nonfiction
Other: Explain



What media do you work with? (Visual Fine Arts Only)



List some of your most recent shows, exhibitions and competitions:



Please indicate the amount you need to complete your current project or series:

$



Have you ever applied for and/or received any other grants?

Yes No


If yes, please specify with what organization, include dates and amounts.



Would you be willing to donate any art to the foundation's permanent collection?

Yes No



Please enter any additional comments or special requests here: