Application Form

Instructions:

Please complete the entire form.  If you are an artist, please submit up to ten (10) photographs of 
your work and a self-addressed, stamped envelope if you would like them returned.  

A non-refundable fee of $35, payable to Visual Arts Italy, is required to process the application.  
Please mail your completed application form and check to the following address: 

Visual Arts Italy
115 W. 29th St., Suite 1103
New York, NY 10011

A detailed schedule and information regarding travel, art supplies and the faculty will be 
provided upon registration.

Name ________________________________________________________________________
Street Address _________________________________________________________________
City ________________________ State ______ Zip Code __________ Country ____________ 
Telephone (day) _____________________________ (eve) _____________________________
E-mail Address __________________________________ Date of birth ___________________
School(s) attended, degree(s) earned and field of study: 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please describe your interest in VAI: 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Please add any information that will help us in considering your application: 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________