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Varuna Residential Masterclass
Application Form




RESIDENTIAL MASTERCLASS: Poetry
DATES OF RESIDENCY: Monday 3th December - Sunday 9th December 2018
APPLICATION DUE BY: 5 September 2018
APPLICANTS NOTIFIED BY: 19 September 2018


Title
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Enter your first name (*)
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Enter your Surname (*)
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No. & Street (*)
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City/Town (*)
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State
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Postcode (*)
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Main phone or mobile (*)
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Include area code - 10 digits, no spaces or dashes
Other phone or mobile
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Email (*)
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eg, myname@domain.com.au

For Varuna's funding bodies it is useful to know the following data (this is not selection criteria).

Do you identify yourself as being of culturally or linguistically diverse background?
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Do you identify yourself as being of Indigenous or Torres Strait Islander descent?
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Do you live more than 100 km from a major metropolitan area?
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Gender
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Your age group?
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How did you find out about the Residential Masterclass?
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If 'other' how did you find out?
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maximum 60 characters
Submission Name (*)
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Submission upload (*)
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ALUMNI DISCOUNT (I am a current Varuna Alumni member and if offered a place would pay the discounted rate):
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Date (*)
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You should save your poems, including the downloadable cover sheet, as a single PDF. The title of your saved document should include your name and the words 'Poetry EOI' (eg Mary Smith Poetry EOI)
(If nothing seems to happen after you press 'Submit', scroll back up the page to make sure that everything is entered correctly. If not there will be an error message in red.)