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Cornaro Residency Application Form

Applicant Information

* First Name

* Last Name

* Address 1

Address 2

* City

* Country

* Postal Code

Landline telephone

Mobile telephone

* Email Address

* Date of Birth

* Sex/Gender

Male

Female

* Nationality (as stated on your passport)

You Are Applying For

* Programme or Course Name

Your Education to Date

* Name of most recent school, college or university attended

* Address of most recent school, college or university attended

* Course(s) studied

* Grades or other results

Other relevant art experience

Your Personal Statement

* Please give a brief description of who you are, give any website addressed showing examples of your work, or use this space to indicate why you would like to take part in the Cornaro Residency programme

If you have a web site showing examples of your recent art work please enter the address (URL) here. This could save us having to request examples of your work from you by e'mail.

Your Referees

Please provide the names and contact details of TWO people who will write a statement in support of your application. If you have been in school, college or university within the last two years then one of the referees should be a former teacher, tutor or official at the school, college or university.

Your referees should NOT be members of your family.

* Name

Title

* Telephone

* Email Address

* Relationship to you (for example, tutor)

* Name

Title

* Telephone

* Email Address

* Relationship to you (for example, tutor)

Declaration

I declare that the information given by me on this form is true; I accept that if I am offered a place on the programme I will be subject to the terms and conditions of the Cornaro Institute/Cyprus College of Art, and that if I accept a place on any programme at the Cornaro Institute/Cyprus College of Art, I will be bound by the Cornaro Institute/Cyprus College of Art, Rules and Regulations.

* If you accept the above Declaration please write your name in this box

* Indicates Response Required