2016朱家角驻留计划申请表-上海-上海喜玛拉雅美术馆.DOC

证大朱家角艺术馆 Zendai Zhujiajiao Art Museum ARTIST-IN-RESIDENCE PROGRAM APPLICATION FORM 艺术家驻留项目申请表 名 Given Name 姓 Surname 国籍Nationality 性别 Gender 生日 Birth Date 护照号 Passport No. 目前职业Current Occupation 教育背景 Education 电子邮箱地址 Email Address 网站（选填） Website (optional) 通讯地址 Mailing Address 邮政编码 Post Code 联系电话（注明国码） Phone (with country code) 紧急联系人姓名 Emergency Contact Name 紧急联系人联系电话 Phone ECN 与紧急联系人关系 Relationship ECN 您之前有来过上海吗？您之前有没有与上海或中国其他城市相关的艺术活动经历？ Have you ever been to Shanghai? Do you have any art experience that is relevant to Shanghai or other places in China? 之前参与过的驻留项目 Other Residencies Attended 您是从什么渠道了解我们驻留项目信息的？ How do you know our Artist Residency Programme? □美术馆官网Shanghai Himalayas Museum website □新浪微博Sina Micro-blog □微信平台 Wechat □亲友推介Friend recommendation □其他Other _______________ 请选择您从事的艺术领域 Please select the discipline that most closely describes your practice needs. 视觉艺术Visual Arts □工作室艺术创作Studio □策展相关Curatorial 写作Writing □文学写作Literature □评论写作Criticism □设计Design □表演艺术Performing Arts □其他Other_____________________ 您希望驻留项目的时长： Desired length of residency: □ 一个月，全时制/1 month, full-time □ 一个月，兼时制/1 month, part-time □ 两个月，全时制/2 months, full-time □ 两个月，兼时制/2 months, part-time □ 三个月，全时制/3 months, full-time □ 三个月，兼时制/3 months, part-time 您希望何时开始驻留项目？ When do you wish to start your residency? 开始日期/From 结束日期/To 第一意愿/First Choice 第二意愿/Second Choice Please make sure that your duration is available for application. 艺术家陈述/Artist Statement 请就您的艺术创作做不超过500字的简述 Please tell us the major themes and ideas within your practice. (Max. 300 words) 简历附件CV/Resume/Biography 请将您最新的简历/个人经历以附件形式附于此表 Please attach your updated Resume/Biography with this application form. 专业推荐Professional Reference 该驻留项目申请要求您为您目前的艺术创作提供两位专业推荐人（姓名及联系方式） As part of your application, you are required to provide two professional references (name and contact), who can comment on your current practice. 第一位专业推荐人/Reference 1 姓名/Name: 目前职业/Profession/Current Position: 联系电话/Phone: 电子邮箱/Email Address: 第二位专业推荐人/Referenc