ARTIST OR CURATOR RESIDENCY PROGRAM 2016 APPLICATION FORM Closing date: Friday 4 September 2015, 5.00pm Amount available: 4 residencies of $11,250 each Please make sure that you have read the guidelines before completing this application form. All applications and support material must be emailed by the closing date to Rachel Arndt, Gallery Programs and Touring Exhibitions Manager at rachela@mgnsw.org.au. Only electronic applications will be accepted. A hard copy submission of the application is not required. All applications received will be acknowledged by return email. If you do not receive an email confirmation, please contact Rachel Arndt on the above email address or 02 9252 8300. It is the applicant’s responsibility to ensure that the submission has been received. Please submit your application using this Word document template. Do not send in PDF format. Support material can be in PDF format. Image based material can be in Powerpoint format. For the transfer of large files over 6MB, Zip files into one folder and send via email. Applications should be forwarded via a single email. For further information please contact Museums & Galleries of NSW on 02 9252 8300. The Artist or Curator Residency program is supported by the Copyright Agency’s Cultural Fund and is managed by Museums & Galleries of NSW. Page 1 of 7 1. Applicant details Organisation: Gallery name (if different from above): Director/Manager: Street address: Suburb: State: Postcode: Postal address: Suburb: State: Postcode: Phone: Fax: Email: Website: ABN: GST registered? Yes No Local government area: 2. Contact details Name of contact: Position: Phone: Mobile: Email address: 3. Legal status Please specifiy the applicant’s legal status Incorporated association Local government department Company limited by guarantee Other If the applicant is not a legal entity such as an incorporated association or a company limited by guarantee, indicate who will administer the grant on your behalf (e.g. local government). Page 2 of 7 4. About your organisation When was the organisation established? Number of paid staff: Number of active volunteers: Please indicate which of the following policy documents and plans your organisation has. Please be aware that M&G NSW might request these documents prior to assessment. Strategic plan Education policy Collections policy Exhibitions policy Annual financial report (audited if applicable) 5. Project summary Please indicate which type of residency you are applying for: Please tick one box only from the selection below. If the proposed resident is both a practising artist and practising curator and this project relates to their capacity in both areas please tick the third box, Artist and Curator. Artist Artist and Curator Curator Name of artist or curator: Name of residency location/host organisation: If the residency location differs from the applicant’s organisation or gallery detailed in section one of this form, please complete the following details. Street address: Suburb: State: Postcode: Phone: Fax: Residency dates: (Must be within 1 January – 31 December 2016). Please note a summary report from the resident Artist or Curator is required within one month of the completion of the residency. Project dates: (Must be within 1 January 2016 – 31 December 2017). Please note a full acquittal report, including financials, is required from the host venue within one month of the project completion date. Name of Project Manager: Please briefly describe the residency project, including the intention and focus (max 50 words). (Please note this summary may be used to describe the project in marketing and promotion should the project be successful. Page 3 of 7 Will the work produced be exhibited or published? Please provide details (max 100 words). 6. Project in detail Project description (max 500 words). What is the aim of the residency and the desired outcome? How/where/when will the residency take place? How does the proposed project relate to your organisation’s strategic plan or artistic program? Creative and professional development opportunities (max 500 words). How will the residency provide a tangible benefit to the artist or curator’s work? Are there other creative or development opportunities resulting from the proposed residency? Education and public program opportunities (max 500 words). How will the residency provide relevant opportunities for audiences to engage with the artist or curator and contemporary art/craft/ideas? 7. Project plan Please provide a project plan and timeline for the residency (i.e. key dates and activities). The residency must occur within 1 January – 31 December 2016. A resulting exhibition or publication can occur in 2017. Activity (what) Date/timeframe (when) Deliverables (how) Page 4 of 7 8. Budget - income Please complete the budget template below for this project. Income Funding Australia Council funding Arts NSW funding Other funding (Local, State or Federal Govt) Budget Notes Please specify: Foundation/other Please specify: Sub-total funding Earned income Admission charges Merchandise sales Other earned income Please specify: Sub-total earned income Other income Gallery contribution in kind Please specify: Cash sponsorship Please specify: In kind sponsorship (dollar value) Please specify: Other Please specify: Sub-total other income Amount requested from ACR $11,250 Total income 9. Budget - expenditure Please complete the budget template below for this project indicating the expenditure and the amount which would be funded by the ACR. All figures should be exclusive of GST. Please note, income must equal expenditure. Amount funded by ACR Artist or curator expenses (See NAVA best practice guidelines) Artist fees Curator fees Other fees Expenditure Budget Notes Please specify: Travel Page 5 of 7 Accommodation Per diems Other Please specify: Sub-total artist or curator Exhibition/new work expenses Materials Equipment Freight Installation and de-installation costs Photography Other Do not include labour costs Please specify: Sub-total exhibition/new work Interpretation expenses Catalogue design Catalogue printing Signage specific to the exhibition Copyright fees Other Please specify: Sub-total interpretation Public program expenses Public program professional fees Equipment hire E.g. AV/computer Workshop support materials Other Please specify: Sub-total public program Marketing and publicity expenses Advertising Printing/photocopying Design Copyright fees Other Please specify: Sub-total marketing Administration expenses Printing/photocopying Other Please specify: Sub-total administration Total expenses $11,250 Page 6 of 7 10. Support material Please include the following support material: Current artist or curator CV or biography (max 1 A4 page) If applying for the artist residency, up to 10 images of artwork and/or 5 minutes video duration inserted into the ACR PowerPoint template issued by M&G NSW, available for download from http://mgnsw.org.au/sector/funding/grants-we-administer/gallery-grants/artist-or-curator-residence/ If applying for the curator residency, examples of the curator’s written work and previous projects (please include source, date, and publication details where appropriate). Letters of support from relevant organisations. 11. Application checklist Application discussed with M&G NSW staff member All outstanding M&G NSW grants acquitted All sections of the application form completed Section 8 completed by an authorised person from the organisation Artist or curator CV attached Examples of artist or curator’s work inserted into ACR PowerPoint template or attached CV for all relevant personnel attached Letters of support from relevant individuals and/or organisations Please note that M&G NSW are unable to return submitted support material. 12. Declaration By checking this box, I agree that I have read the guidelines relating to the grant program. I certify that to the best of my knowledge, all the information in this application is correct and has been approved by the board of management or relevant authority, and that I have the delegated authority to sign this application. Name of authorised person: Position: Date: The ACR grant program is enabled with funds from the Copyright Agency’s Cultural Fund. If these funds are no longer available, M&G NSW may be unable to run this program and not provide full or part funds. Page 7 of 7