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YUI-PORT Niigata City Center for Creative Arts and International Youth Exchange

Artist in Residence Program “Autonomous Activity Program 2021 Winter”

Application Form

Year Month Date

1. Applicant

|Name |The name of all applicants | |

| |(in case of group application) | |

| | |Please attach your |

| | |face photo |

| | |*Only representative |

| | | |

|Activity base |The number of applicants:　 | |

|Birthplace |Nationality: | |

|Birth date:　　 　 Year　 Month 　　　Date |Age:　 | |

|Current Address: |Tel: |

| |E-mail: |

| |Emergency contact tel: |

|Major genres of artistic | |

|expression | |

|Available language |☐ Japanese　☐ English　☐ French　☐ Korean　☐ Russian　☐ Chinese |

| |☐Other（　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　） |

|Have you ever been to Japan? (* Only for overseas residents)　　　 ☐ Yes　　　☐ No |

|Period, Location, Purpose | |

|Where did you get the information about YUI-PORT open recruitment? |

|☐Official website　　　☐Official SNS （Facebook,Twitter） ☐Other websites　　　　　　　　　　　　　　　　　　　 |

|☐From Friends and acquaintances　　　　　☐Others　　　　　　　　　　　　　　　　　　　 |

2. Motive for Application

Please describe your motivation for applying for this program. (Please write within 250 words)

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3. Profile

|Biographical Information　(Please write up to 5 main things.) |

|Year |Month |Educational background, degree, work history, etc. |

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|History of Activities　(Please write up to 5 main things.) |

|Year |Month |History of major exhibitions and projects, etc. |

| | | |

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|History of Artist-in-Residence (Please write up to 5 main things.) |

|Year |Month |Project name, country/city, host organization, etc. |

| | | |

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4. Plan of Work During Residence

|Your request for |First choice |From 2021 　Month Date to 2021 　Month Date ( Days) |

|duration of stay | | |

| |Second choice |From 2021 　Month Date to 2021 　Month Date ( Days) |

Schedule of work and stay (Please write briefly according to the schedule of your first choice.)

|Date |Outline |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

|Month/Date – Month/Date | |

5. Plan of Creative Activity During Residence

　Please write the plan for your work activities during this program period.

|Theme of Plan | |

|Outline | |

|Please write about your work activities. (Please write within 400 words.) |

6. Idea of Citizen Exchange Project

Please write your proposal for lecture and workshop or plan etc. for exchange activities by collaborative work and projects etc.

|Theme of Project | |

|Outline | |

|Please write about your project. (Please write within 400 words.) |

7. Material of Your Work

①Up to 3 images of works

* The data capacity of each work image shall be less than 1 MB, and the description of each work shall be within 200 words.

|1 |Title |Production year |Material |

|* Please attach the image of the work. |Size |

|(Less than 1 MB) | |

| |Explanation |

|2 |Title |Production year |Material |

|* Please attach the image of the work. |Size |

|(Less than 1 MB) | |

| |Explanation |

|3 |Title |Production year |Material |

|* Please attach the image of the work. |Size |

|(Less than 1 MB) | |

| |Explanation |

②Up to 3 video works (optional)

Please upload the video files to video streaming service such as Youtube and attach the URL.

* The total length of the video shall be within 10 minutes and the description of each work shall be within 200 words.

|1 |Title |Production year |Running time |

|URL |http:// |

|Description |

|2 |Title |Production year |Running time |

|URL |http:// |

|Description |

|3 |Title |Production year |Running time |

|URL |http:// |

|Description |

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