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ellen stewart international award_application

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ellen stewart international award_application
Ellen Stewart International Award - 1° Edition 2015/2016
APPLICATION FORM - Deadline 30 November 2015
Send by mail to: [email protected]
Date:______________________________
Name of Nominator:__________________________________________________________
____________________________________________________________________________
Name of Nominee(s): _________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Address of Nominee(s): _______________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Phone: ______________________________ Mail: __________________________________
web site: ___________________________________________________________________
Link: _______________________________________________________________________
1) Short bio of Nominator (200 words)
pag 1 / 4
2) Short bio of Nominee (500 words)
3) Describe why the Nominee is appropriate to be the recipient of the Ellen Stewart
Award, including the impact of the work on community and youth (500 words)
pag 2 / 4
4) What key accomplishments of the Nominee most impress you? (200 words)
5) Please include link to photographs and/or video clips of the Nominees’ relevant
theatrical work (All documentation must be in digital form, accessible online)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
pag 3 / 4
6) Please include a maximum of 5 press references to the Nominees work.
(All documentation must be in digital form, accessible online)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
7) List the Names of Supporters who have written the attached Letters of Support
with their contact information:
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
Date_______________________ Signature _______________________________________
pag 4 / 4
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