Open Studio Registration Form

	To register your interest in this initiative please complete the form below and click the 'Send' button.
	Artists must be a Waitakere City resident or a member of a Waitakere Art Group
	Please also attach a separate email or post an image of yourself, your work or your studio by 19 January 2010.
	Note: Images are essential for the brochure - see the bottom of the form for more details on sending images

	Compulsory fields are marked with **

	I would like to participate in the Open Studio weekend

	Name: **

	Your email:**

	Contact Phone number **

	Mobile Number

	Address **

	Art Discipline **

	Home Studio/ Cluster/Gallery?**
	For more information about clusters available contact the email address below

	If you selected Cluster or Gallery above please supply the address


	I will be open? **

	I am able to accommodate a mini-bus tour? **
	(ie. adequate parking available on road) Maximum 17 seater bus for 20 minute visit. Note: Tour route to be decided at coordinator's discretion. You will be notified if you are to be included in the tour)

	I can provide toilet facilities?**
	(Note: if you have said 'yes' to the bus tour you must be able to provide toilet facilities)

	Agreement** By agreeing to opening my home studio at the set dates as above I commit to being available and open to visitors, and will exercise courtesy and respect to visitors at all times.


	Images: **- Sent by email/Sent by Post
	Photos or a CD of images are accepted

	Plans are underway to create a more permanent 'Waitakere Arts Trail' brochure for artists.
	Please indicate if you would be interested in this initiative.**

	Please ensure you clearly label and name your images for identification purposes.
	If posting, send to: Community Arts Coordinator, Waitakere City Council, Private Bag 93109, Henderson, Waitakere City
	If emailing send to: Julie.Nash@waitakere.govt.nz
	For enquiries contact Julie.Nash@waitakere.govt.nz Ph 09 836-8000 Extn 8934 Fax: 09 836-8001