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Application Forms (Artist) 2008 Fukuoka Asian Art Museum Artist in Residence Program 2008 Application Form 1 Name Sex Nationality Place of birth Primary language(s): 1 2 Home address (required) Date of birth (Attach photo) Marital status 3.5cm×4.5cm Other languages 1 2 3 Tel Email Work Fax Mobile Tel Email Other ( ) Fax Tel Email Fax Application Forms (Artist) 2008 Fukuoka Asian Art Museum Artist in Residence Program 2008 Application Form 2 1. CV (Please write no more than 5 selected items of education, work experience, etc.) (Year) 2. Past exhibitions (Please write no more than 10 selected solo and group exhibitions) (Year) 3. Please state if you have any experience of Artist in Residence Programs in the past (Up to 5 items) (Year) Application Forms (Artist) 2008 Fukuoka Asian Art Museum Artist in Residence Program 2008 Application Form 3 1. Please select a time period from below (Check one of them). 7 May to 4 August 2008 10 September to 8 December 2008 7 January to 31 March 2009 Either of the dates 2. How did you hear of this program? 3. Reasons for application Application Forms (Artist) 2008 Fukuoka Asian Art Museum Artist in Residence Program 2008 Application Form 4 Plan of collaborative art-making with the people of Fukuoka Content and work schedule (Please attach drawings separately) Method for collaborative art-making with the people of Fukuoka Application Forms (Artist) 2008 Fukuoka Asian Art Museum Artist in Residence Program 2008 Application Form 5 Proposal for workshop (If you have several plans, please use a photocopy of this form for each plan.) Title Target groups Please state which group of people you would like to work with. (Eg. Adults, college students, high school, junior high school, elementary school students, children (or preferable age), parents and children etc.) Content (Please include drawings in this frame, if any) Application Forms (Artist) 2008 Fukuoka Asian Art Museum Artist in Residence Program 2008 Application Form 6 I would like to recommend the below-mentioned artist for the Fukuoka Asian Art Museum Artist in Residence Program 2008. Name of the artist Date This form must be filled in by the recommender. Name of the recommender Signature Nationality Occupation Name of the organization or institute Address of the organization or institute Tel Home address Tel Email Relation with the artist Reasons for recommendation Fax Mobile Fax Position

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