Application form Mixed Media – Ceramics plus The ... - Keramik-Atlas

Mixed Media – Ceramics plus
The Nassauische Sparkasse 2010 Talent Award for Ceramics
Application form
Entry no.
Please save this form on your
computer and send it filled in to:
info@keramikmuseum.de
or as printed version by mail to:
Keramikmuseum Westerwald
Lindenstraße 13
D-56203 Höhr-Grenzhausen
(for internal use only)
Surname
First name
Gender female male
Nationality
Postcode, City
Street
Telephone
Date of birth, Place of birth
I accept the terms of the competition
and confirm that I have
designed and executed the
work myself.
Place, date
Signature
The catalogue will be based
on the following information.
Please give detailed information.

What were the reasons for
your choice of career?
Curriculum vitae,
training and job:
Period from/to Place Occupation/qualifications Teacher Job title
Self-employed since
in
Studio shared with

Publications:
Exhibitions/Awards:
Year Place Museum/Gallery etc. Catalogue, page
Additional information:

Mixed Media – Ceramics plus
The Nassauische Sparkasse 2010 Talent Award for Ceramics
Object form
Surname, First name
Please save this form on your
computer and send it filled in to:
info@keramikmuseum.de
or as printed version by mail to:
Keramikmuseum Westerwald
Lindenstraße 13
D-56203 Höhr-Grenzhausen
Gender female male
Description of object 1
Description of object 2
Made in (year)
Dimensions
Retail price (insurance value)
For sale yes no
Bank details
Account number
Bank sort code
IBAN
BIC
Details on material and technique:

Thoughts on the object,
on artistic aim, on the topic:
Place, Date
Signature