Application Form Q-International Spring 2018 1. General details of the applicant organisation Name of organisation Email address Telephone number Website Address ZIP Code/Postcode City Country VAT number Legal status 2. Contact details of the reference person Title Name Surname Email address Telephone number Role
Contact details of the legal representative Title Name Surname Email address Telephone number Role 3. Bank details of the applicant organisation Bank name Bank city Account number or IBAN BIC (or SWIFT) Code 4. Details of the initiative Please provide the title of the initiative you are applying for Please provide the list of the Italian artist(s) you are applying for 5. Documents in PDF to be attached to this application form 1. information sheet about the applicant organization (max 4000 characters including spaces) 2. general plan for the exhibition and/or initiative, highlighting the Italian participation in the case of group exhibitions (max 4000 characters including spaces), accompanied by some images of the works with captions (max 10 images or 8 MB) and by the communications plan for the initiative (max 2000 characters including spaces) 3. CV of the Italian artist(s) for whom the grant is being requested, accompanied by a short introductory text and a portfolio of images (max 10 MB) 4. declaration signed by the Italian artist(s) authorizing the organization to apply (max 1500 including spaces) 2
6. Budget of the whole initiative Please provide a breakdown of the budget of the whole initiative Production of work(s) Shipment Insurance Installation Audio/visual services Other installation expenses Artists travel expenses Artists accommodation and per diem Fees of the invited artists Translation/subtitles Communications Advertising Catalogue Opening night and Public Relations Public Programme Documentation Other TOTAL IN EUROS 3
7.1. Total funding requested from Q-International for the Italian participation EUROS 7.2. Itemized breakdown of funding requested from Q-International for the Italian participation 1) economy class travel for artists and performers for the installation of the work and inauguration of the exhibition 2) accommodation for artists and performers 3) fees for performers 4) transport of the works and related insurance costs during transport 5) hire of audio-video equipment required for the presentation of the work 4
6) publication of the catalogue and other publications, in paper and digital form 7) translation of subtitles into languages other than Italian 8) Public Programme activities (travel and accommodation for artists and speakers, audio and video recording of talks) 9) documentation of the exhibition (photo and video services) TOTAL IN EUROS *Please provide a brief explanation of the costs N.B. Please note that the expenses specified in the budgets must be expressed in EUROS. The total funding that each applicant organization may apply for cannot exceed the maximum amount of 12,000 euros (twelve thousand/00 euros) including taxes. Funding may also be granted for partial amounts of each requested item of expenditure indicated in the application. 5
8. Declarations I declare that the organization that I represent is a legal entity established before 2014 Date, Signature of the legal representative I hereby declare that I have read the Call for Applications Q-International aimed at exhibition initiatives realised by non-italian organisations featuring one or more Italian artists and I agree to abide by the rules. I Agree Date, Signature of the legal representative I authorize the Fondazione La Quadriennale di Roma to process personal data in accordance with current legislation. Date, Signature of the legal representative 6