Application Form Keyholder Residency Application Form Press tab to navigate between fields, and do not press return until you're ready to submit the form. Application Checklist Up to 8 images of recent work. Images should be JPEG format, longest dimension maximum 1,000 pixels, 72 dpi, RGB color mode. Title each image as "Last name_First name_#" ( for ex. Smith_Pat_01.jpg). Image list: your name, work title, year, medium, and dimensions (PDF Format). Title your image list as "Last name_First name_Imagelist” (for ex. Smith_Pat_Imagelist.pdf). Artistic resume (PDF Format). Title your resume as "Last name_First name_Resume” (for ex. Smith_Pat_Resume.pdf). Your Name* First Last Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Enter Email Confirm Email Please provide a brief artistic statement*(Limit your response to 1,000 characters, including spaces)How did you learn about the Keyholder Residency?*Listing (Publication/Website)Lower East Side PrintshopNYFAOtherOther*Do you have printmaking experience?*A lotA littleNoneWill you have access to a studio space in the next year?*YesNoIf awarded the residency, briefly describe how access to printmaking facilities would affect the progress of your work in the coming year:*Please attach your Artistic Resume (PDF)*Accepted file types: pdf.Title your resume as "Last name_First name_Resume” (for ex. Smith_Pat_Resume.pdf).Please provide name and contact information for two professional references below:Reference #1*Reference #2*Image UploadPlease attach up to 8 images of recent work. Images should be JPG format, longest dimension maximum 1,000 pixels, RGB color mode. Title each image as "Last name_First name_#" (eg. Smith_Pat_01.jpg). Maximum image size is 2MB.Image File 1Accepted file types: jpg, jpeg, gif, png, pdf.Image File 2Accepted file types: jpg, jpeg, gif, png, pdf.Image File 3Accepted file types: jpg, jpeg, gif, png, pdf.Image File 4Accepted file types: jpg, jpeg, gif, png, pdf.Image File 5Accepted file types: jpg, jpeg, gif, png, pdf.Image File 6Accepted file types: jpg, jpeg, gif, png, pdf.Image File 7Accepted file types: jpg, jpeg, gif, png, pdf.Image File 8Accepted file types: jpg, jpeg, gif, png, pdf.Please attach an image list of your submitted work (PDF)*Accepted file types: pdf.Please include your name, work title, year, medium, and dimensions in your image list. Title your image list as "Last name_First name_Imagelist” (for ex. Smith_Pat_Imagelist.pdfOptional InformationThe following information is collected for statistical and reporting purposes to the PrintShop's funders only; it will not affect your application, and it is optional. EthnicityCaucasianAfrican AmericanAsian/Pacific IslanderHispanicNative AmericanNationalityChoose NationalityAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweGenderMaleFemalePrefer Not to AnswerOther ** If other (gender), please specify:Pronounhe/himshe/herthey/themDate of Birth PhoneThis field is for validation purposes and should be left unchanged. 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