Application Forms (Researcher/Curator) 2013

(Submit the printed hard-copy and the digital file on CD-R)

Fukuoka Asian Art Museum Researcher/Curator in Residence Program 2013

Application Form 1 Personal Data

Name
（Attach photo）
3.5cm×4.5cm
Sex / Date of birth
Nationality / Marital status
Place of birth / Other languages1
2
3
Primary language(s): 1
2
Home address（required）
Tel Fax
Email Mobile
Work
Tel Fax
Email
Other（ ）
Tel Fax
Email

(Submit the printed hard-copy and the digital file on CD-R)

Fukuoka Asian Art Museum Researcher/Curator in Residence Program 2013

Application Forms 2Curriculum Vitae

1. CV （Please write no more than 7 selected items of education, work experience, etc.）

(Year)

2. Past curation, projects, essays (up to 10 items)

Year / Title of exhibition, project, essay, etc / Content

Fukuoka Asian Art Museum Researcher/Curator in Residence Program 2013

Application Form 3Proposal 1

1. Period of stay

Please enter a preferred period of stay (42 days max) between 15January and 25 March 2014.

Second choice：(date) (month) to (date) (month) 2007 ( days)

2. How did youhear of this program?

3. Reasons for application

Fukuoka Asian Art Museum Researcher/Curator in Residence Program 2013

Application Form 4 <Proposal 2

Research plan

Theme
Brief overview (No more than 250 words of English)
Working schedule

Fukuoka Asian Art Museum Researcher/Curator in Residence Program 2013

Application Form 5 <Proposal 3>

Plan of educational program

（If you have several plans, please use a photocopy of this form for each plan.）

Title
Target group / Please state which group of people you would like to work with. (Eg. Adults, college students, high school, junior high school, elementary school students, children (or preferable age), parents and children, etc.)
Duration/
How many times? / Approx. Hrs/ mins sessions
Content (No more than 250 words of English)

Fukuoka Asian Art Museum Researcher/Curator in Residence Program 2013

Application Form 6Letter of Recommendation

I would like to recommend the below-mentioned researcher/curator for the Fukuoka

Asian Art Museum Researcher/Curator in Residence Program 2013.

Name of the researcher/curator

Date Signature

This form must be filled in by the recommender.

Name of the recommender / Nationality
Occupation / Position
Name of the organization or institute
Address of the organization or institute
Tel Fax
Home address
Tel Fax
Email Mobile
Relation with the researcher/curator
Reasons for recommendation