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Name

First Name

Last Name

Preferred Pronoun

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone

(###)

###

####

Business Name (if applicable)

Business Web Address (if applicable)

Studio you are interested in:

Would you consider sharing a studio?

Yes

Handicap Accessibility

Not all of our studios are ADA accessible. Do you need an accessible space?

Yes

Artistic Media

please specify any special equipment and materials that your work requires and your specific intent to responsibly store, use, ventilate and dispose of such. There is zero-tolerance for inappropriate storage, use or disposal of dangerous materials.

Materials that require special handling

If you will use materials that require special storage, use, ventilation, or disposal please describe here.

What will your studio hours be?

Specify the hours and days that you typically spend in studio. Please specify a.m./p.m.

Please list any grants, scholarships, employment, crowdfunding, or any other revenue streams that you receive to support your artistic practice.

Artist Statement

Link to reference materials

Link to your website, dropbox, icloud, google drive, etc. with references to your work. You may also email info@interurbanarthouse.org if you are having difficulty.

http://

I am applying for studio

Please indicate which open studio you are applying for

If you would like to be considered for financial assistance:

Please indicate the amount you are able to pay each month for studio space at InterUrban ArtHouse. Although not guaranteed, all requests will be considered.