Copland House Residency Application
Email address *
First Name *
Last Name *
Mailing Address *
street, city, state, zip (& country, if outside the US)
Phone number
Birthdate *
MM
/
DD
/
YYYY
Birthplace *
city, state
Performing Rights Affiliation *
I attest that I am a U.S. Citizen or Permanent Resident, and will promptly provide residency documents to Copland House, if requested. *
Official proof of citizenship or residency includes U.S. birth certificate, U.S. passport, Board of Elections registration card, or USCIS document. Neither driver's license nor Social Security card is acceptable.
Required
Attach a brief 1- or 2-page resume with educational background, professional activities (commissions, performances, awards, etc.), and works list. Include a short description of the creative work you hope to accomplish while in residence at Copland House. What will this project mean to your career? *
Required
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