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5 Lands Walk Ephemera Artist Application Form

First Name

Last Name

Email

Street Address

Suburb

State

Postcode

Mobile

Do you identify as a First Nation's artist?

Do you identify as a First Nation's artist?
A
B

If Aboriginal, What is your Nation?

Bank details for transfer of nominated artist’s stipend payment:

Legal Account Name:

BSB Number:

Account Number:

Describe your artwork

Give context, build understanding around your piece. (To be read by committee only/not published elsewhere) 200 words or less

Materials to be used

What materials were used to create your artwork?

What size is your artwork?

Approximate measurement of entire submission. L x W x H (metres)

ARTWORK SIGNAGE: Title of artwork

What is the name of your artwork?

ARTWORK SIGNAGE: Artist's Name

What Artist name do you want associated with your artwork?

ARTWORK SIGNAGE: Signage Statement

Short story or statement about your artwork (25 words or less).

Safety Statement

All sites are on the sand at Avoca Beach and open to extreme weather changes, tidal variation, and public interaction. Please consider this when submitting your application. All artwork must be safely secured. Description how safety has been addressed.

File Upload (upload photo or detailed drawing of your proposed artwork as .docx, .pdf, jpeg, .png, .jpg).

I give permission for photographs of my work to be used for 5 Lands Walk and Ephemera promotional material including websites and social media

I give permission for photographs of my work to be used for 5 Lands Walk and Ephemera promotional material including websites and social media
A
B