bookings supporters membership volunteers visitor infolinkscontacthome


Book Online
Murray Darling Palimpsest
Previous Page
Mildura Palimpsest Triennial Application Form
Thank you for your interest in participating in the Mildura Palimpsest.
Please provide us with the following information.

  *Denotes required fields
Group Artist / Name:*
Where are you based:*
Contact Name:*
Telephone:*
Mobile:
Email Address:*
Website:
Would you require a fee? Yes No
Requested Fee:
   
Have you applied for funding to support your project? Yes No
When is the outcome known?
Do you intend to apply for funding to support your project? Yes No
When is the outcome known?
   
Description of Work
(250 word Max.):*
   
Biography (250 word Max.):*
 
In addition please post an exhibition proposal and portfolio to:
Mildura Palimpsest
PO Box 1982 Mildura Victoria 3502
   
Would you like to receive updates about upcoming events? Yes No
 
   

Privacy
We will only use personal information provided by you for the purposes for which
it was collected. We will not disclose your personal information to a third party.