Humanities SA form - The British School at Rome

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Fee
Office use only
WF
CD/DVD
DEREK HILL FOUNDATION SCHOLARSHIP (October–December 2016)
APPLICATIONS SHOULD BE SENT TO THE REGISTRAR, THE BRITISH SCHOOL AT ROME, 10 CARLTON HOUSE
TERRACE, LONDON, SW1Y 5AH, TO ARRIVE NO LATER THAN FRIDAY 29 JANUARY 2016.
APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED.
Please ‘type’ or complete in BLACK ink. Please ensure that the pagination matches the indicators for the end of each page.
The form is available as a Word document at www.bsr.ac.uk/awards/fine-arts.
You may, if eligible, also apply for the Rome Fellowship in Contemporary Art and Sainsbury Scholarship in Painting and Sculpture
(for which separate applications are required) and pay just one entry fee.
1.
Name
3.
Tel.
E-mail
2.
Address
4.
Date of birth if aged 23
or under
5.
Nationality
6.
Present Occupation
7.
Further and Higher Education (College/University, Dates, Qualifications (with grades))
8.
Exhibitions
Give details of exhibitions where your work has been shown publicly other than as part of any courses in question 7. If there is not
sufficient space to list all your exhibitions, please limit yourself to selected exhibitions. Do not attach extra sheets.
9.
Awards, Prizes and Publications
End of page 1
Name
10.
Professional Experience
11.
Can you speak and/or read Italian?
12.
Have you already visited Rome or Italy? Please give details.
13.
Where did you hear about the residency?
14.
Surname
Names, postal addresses, telephone numbers and e-mail addresses of two referees who are familiar with you and your
work.
1.
2.
Name
Address
Telephone
E-mail
15.
Please answer question 15 on page 3.
An entry fee is payable. It is your responsibility to ensure that you have read the eligibility criteria
carefully: the entry fee is non-refundable.
16.

I enclose the entry fee of £25
(in the form of a sterling cheque drawn on a British bank payable to ‘The British School at Rome’)
OR

I wish to pay by credit or debit card (£25)
If you wish to pay by debit or credit card (Visa, MasterCard, Maestro-UK, Debit MasterCard, Visa Debit, American
Express, JCB, Diners, Laser, Electron), you may complete the attached form (which will be destroyed once the payment
has been taken) or may phone us on 020 7969 5332 to give your card details on Tuesday 2 February.
OR
17.

I have also applied already for the 2016–17 Rome Fellowship in Contemporary Art and/or Sainsbury
Scholarship in Painting and Sculpture (in which case no further entry fee is required)

I enclose a CD/DVD with work, as detailed on the form on page 4 OR 5
It is anticipated that interviews will be held in London in early March. Candidates will be informed of the precise date
when we acknowledge receipt of an application shortly after the closing date.
Candidates resident in the UK will be required to attend an interview in person in London. Those resident outside
the UK may be interviewed via skype if they wish (but should note that this has implications for showing work).
I confirm that the information given in this application is, to the best of my knowledge, complete and accurate.
Submitting this form constitutes your acceptance of all the terms and conditions contained in the announcement of this residency.
Signature
Date
End of page 2
Name
15.
Surname
Why are you applying for a residency and what do you expect to gain from a period spent in Italy? You should note the
aims of this Scholarship, to encourage artists for whom the use of paint and/or drawing is central to their practice.
(The maximum length is 550 words, minimum font size 10pt. Please adapt your proposal to fit the space provided: do not continue
overleaf and do not attach extra sheets.)
DISABILITY
Applicants with special needs are requested to contact the Registrar before submitting their application to discuss their requirements.
The British School at Rome is registered under the Data Protection Act 1998 [Registration Number: K0335060] and adheres to the Data Protection
Principles. Applicants should be aware that information they provide will be stored in electronic form. It will be provided to those who assess
applications and to staff of the BSR, and will be used to compile published lists of award-holders.
End of page 3
Complete EITHER page 4 OR page 5
List of images submitted in support of application for:
Derek Hill Foundation Scholarship
Name of candidate: ...........................................................................................................................................
You should submit up to ten images of at least five pieces of your recent work. You should take note of
the aims of this particular Scholarship when you select the images. They should be sent on a CD-Rom
with the images saved in RGB JPEG digital file format, at a screen-based resolution of 72 dpi, with ideal
dimensions of 1024 × 768 pixels. Please ensure that JPEGS and CD-Rom are PC-compatible. The files
should be named as follows: first four letters of your surname, first letter of your first name, number
corresponding to the image list (e.g. Gill Clark’s third image — clarg03).
Please complete the table below in typescript or, if this is not possible, in block capitals in black ink.
Image
no.
Title of work
Size (in cm)
Height
Width
Year of
completion
Medium
01
02
03
04
05
06
07
08
09
10
No images in excess of this number will be examined.
End of page 4
Complete EITHER page 4 OR page 5
DVD submitted in support of application for:
Derek Hill Foundation Scholarship
Name of candidate: ...........................................................................................................................................
You should submit one DVD with a show-reel of your own recent work, lasting five minutes. You
should take note of the aims of the Scholarship when you select the work. The DVD must be PAL
(Region 2/Europe-compatible) and should contain only the five-minute show-reel you would like the
selectors to view. The DVD should be clearly marked with your name.
Please complete the table below in typescript or, if this is not possible, in block capitals in black ink.
Title(s) of work(s)
Year of completion
Brief description of the extracts in your show-reel, and details of how the extract relates to the whole work:
The viewing of this DVD will be strictly limited to five minutes.
End of page 5
Application for:
Derek Hill Foundation Scholarship
Please charge the competition entry fee of £25.00 to the following card.
 Visa/Delta Electron  Mastercard
 American Express
 Solo/Maestro
Name on card: _________________________________________________________________
Card number: __________________________________________________________________
Start date (if given): ____________________________________________________________
Expiry date: _____________________________________________________________________
Issue no. (Solo/Maestro): ______________________________________________________
Card security no. (three digit number from the reverse): ___________________
Billing address: _________________________________________________________________
____________________________________________________________________________________
E-mail address to which the receipt for the transaction can be sent:
____________________________________________________________________________________
Signature: _____________________________________________ Date: __________________
Please note: all of your card details will be destroyed once the payment has been processed.
If you do not wish to send these details on this form, you may phone us on 020 7969 5332 on
Tuesday 2 February (10.00–13.00, 14.00–16.30 London time).
The British School at Rome
Monitoring Form
As part of the British School at Rome’s commitment to equal opportunities, the age, gender and ethnic
origin of people who apply is monitored. We should be grateful, therefore, if you would complete this
form. Any information that you give will remain confidential. The form will be detached from your
application, will not form any part of the selection process, and will be used only for the purposes of
monitoring.
Please do not sign the form or give your name.
Thank you for your cooperation.
Date of birth (dd/mm/yyyy)


Female
/

Male
/
Prefer not to say
Please show which group best describes your ethnic origin or descent by ticking ONE of the boxes below.
The groups are derived from the 2001 census categories, as recommended by ACAS.
Asian or Asian British


Bangladeshi

Any other Asian
background, please
write in box
Indian

Pakistani
Caribbean

Any other Black background,
please write in box
Black or Black British


African
Chinese


Chinese
Any other, please write in box
Mixed heritage

White and
Asian

White and
Black African

White and
Black
Caribbean

Any other mixed
background,
please write in box
White
 British 
English

Irish

Scottish

Welsh

Any other White
background,
please write in box
Other ethnic group

Any other ethnic group, please write in box
Decline to specify

Do you consider yourself to have a disability?
Hill 2016–17

No

Yes
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