Financial Support Application Form » Kimberley Art and Photographic Prize

First Name*

Last Name*

Birth Sex

FemaleMale

Do you identify as Aboriginal or Torres Strait Islander?*

AboriginalTorres Strait IslanderNeither

Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Community of usual Residence

Email Address*

Phone Number*

Community Contact / Secondary Contact

I have received approval to share contact details from my secondary contact

YesNo

Supply a brief description why you require support*

What would you like assistance for? Please choose only 2*

Entry FeesHanging systems ($40)Canvas stretching (Up to $x100)Art Supplies (Up to $100)

Attach Quote for requested support*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Are you normally sponsored by an Art Gallery*

YesNo