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:

Country:

Phone:

Fax:

E-mail:

URL:

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

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?

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?

Please enter any additional comments or special requests here: