* Required Fields

1. CURRENT SITUATION

* Safemuse provides residencies for artists at risk, artist that are threatened, persecuted or censored because of their art. In order for us to assess your application we need a description of your current situation, including details of threats, persecution, censorship, or other limits to your artistic freedom of expression.

 

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2. PERSONAL DETAILS

* Current address:

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* If you live in another country than your birthplace, what is your status:

CitizenshipPermanent ResidencyTemporary ResidencyAsylumTouristOther

* Do you have a Schengen visa?

NoYes

If yes, please state the expiration date:

 

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3. ARRIVAL TO CURRENT COUNTRY OF RESIDENCE/ASYLUM

In the event of you having left your country of birth

Meetings with local authorities, international organisations (e.g. UNHR): Describe in detail the official meetings and if possible refer to official files recording your case:

Contact details of individuals and/or organisations that you have been in contact with regarding your case:

Name or organisation: Address: Person(s) dealing with your case: Contact details:

 

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4. ADDITIONAL INFORMATION

* Have you received any other scholarships or grants for the period in question?

NoYes If yes, please describe:

 

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5. PROFESSIONAL DETAILS

* Name of relevant employer(s), groups or companies you have worked with: * Recordings/ videos/ publications/ published work and type (including possible links to clips and recordings available on the internet) - pdf & links only:

Upload relevant documents, only pdf (max 2MB each):

 

Are you working on a project or/and have an idea of what kind of project you would want to work on during the residency? Please elaborate:

 

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6. PROFESSIONAL DETAILS – CIVIL AND POLITICAL

Indicate if you are a member or employee of a professional union or association. Please provide the name of the organisations and brief details of activities and dates of membership:

* Have you had any previous cooperation with Norwegian artists:

YesNo

* Have you had any previous cooperation with European artists:

YesNo

If yes, please describe:

 

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7. REFERENCES

Please provide the names and addresses of two persons who can comment on your work as an artist, and on your present circumstances. It should be possible to contact your references by email or telephone. It is advisable to ensure that your referring individuals are willing to be contacted by Safemuse in confidence. We will contact them as part of the application process:

* 1st Reference

Postal Address: Relationship to applicant (For example: is this person a fellow writer, employer, individual or representative of organisation with specialist knowledge of your situation and/or the general state of freedom of expression and other human rights in your country):

2nd Reference

Postal Address: Relationship to applicant (For example: is this person a fellow writer, employer, individual or representative of organisation with specialist knowledge of your situation and/or the general state of freedom of expression and other human rights in your country):

 

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8. EMERGENCY CONTACT

Please provide two persons that can act as emergency contacts for you. These persons must be informed about this listing, and it should be possible to contact your emergency contacts by email and/or telephone.

* 1st Emergency contact

 

* 2nd Emergency contact

 

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9. PREFERRED RESIDENCY LOCATION

Safemuse organize safe residencies both in Oslo and Hvitsten. Please indicate which of the residencies would be your preference:

OsloHvitsten

 

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10. OTHER INFORMATION

Please describe anything else relevant to your case:

 

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11. TERMS OF RESIDENCE

 

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12. CONFIRM AND SUBMIT

 

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All information contained herein is strictly confidential and to be utilized internally and only by Safemuse. This application is submitted to a closed, secured web-base.

 

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