ARTIST-RESIDENCE PROGRAM

APPLICATION

GYEONGGI CREATION CENTER /　GYEONGGI MUSEUM OF MODERN ART

NAME:                                                                       □MALE  □FEMALE

First Name                       Last Name                     Middle Initial

ADDRESS:

TELEPHONE:                                     E-mail:

Please include country code and city code for telephone and fax numbers.

CURRENT POSITION:

DATE OF BIRTH:                                IN:

Month        Day        Year                  City                     Country

■ MOVING THE FIELD (Please check only one)

□ Creative Residency Program        /       □ Research Residency Program

■ SCHEDULING PREFERENCE (Please check only one)

□ Long Term (1 Year) March 2011 - February 2012

□ Short Term (3 Months / 6 Months)

1) 3 months: 3/4/5(March-May), 6/7/8(June-August),

9/10/11(September-November), 12/1/2(December-February 2012)

2) 6 months: 3-8(March-August), 9-2(September-February 2012)

■ ATTATCHED DOCUMENTS

Should include the following materials with this application form,

□ CV or resumé

(include detailed information on your previous experience with the media you wish to use at GCC)

□ A project description of intended activity during the residency

□ Portfolio/Work samples (CD/DVD) : maximum 20 images or 5 minutes of video (Video only for media artist)

□ Copy of passport or I.D Certificate

I apply to 2010 Gyeonggi Creation Center Residency Studio Program.

day     month     year

Applicant                                   Signature