EmailMe Form - Peace Foundation Award at Adelaide Fringe

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Contact Person *
First Last
Company/Organisation
Email *
Web Site
Telephone Number *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Title of Performance or Exhibition *
Date/s and Location of Performance and Exhibition *
Checkbox *
Promotes Human Rights
Supports Indigenous People's Rights to Economic Self-determination
Promotes Peace as a way of solving conflict
Promotes care of environment and sustainable development
Supports justice for oppressed peoples
Select all that apply
Brief Description of Performance or Exhibition *
How does this performance or exhibition address the objectives? How do you hope your audience connects with these issues through the performance or exhibition? *
What opportunities or plans are in place for future performances or exhibitions? *
How would the award contribute towards reaching future audiences? *
Please list the participants in the performance or exhibition and their role. *
Referee Details #1: *
Enter Name, Address, Telephone and Email of the Referee
Enter Name, Address, Telephone and Email of the Referee
Referee Details #2: *
Enter Name, Address, Telephone and Email of the Referee
Enter Name, Address, Telephone and Email of the Referee
Do you have supporing material with your application? *
Yes, attached below electronically
No
Supporting material will not be accepted via mail.
File Upload 1
Upload Supporting Material #1
File Upload 2
Upload Supporting Material #2
File Upload 3
Upload Supporting Material #3
Terms and Conditions *
I have read and accept all the conditions of entry listed on the information page on the Peace Foundation website
Information Supplied is True and Correct - by ticking this box, it acts as a signature by you: *
I give my assurance that to the best of my knowledge, the information supplied for this application is true and correct at this date.

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