Bollard Art Project Opportunity Use this form to register your interest in an opportunity to refresh the bollards with 'Midwest Life' designs. Save Your ProgressYou have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address. Email Address: * Required Field * Must be a valid email. Password: * Required Field There is no way to resend or recover your password, please write it down. Note: Incomplete forms are kept for a period of 2 day(s), after this time the system will automatically delete your response. Artist Details Artist/Group Name:*This field is required. * Required Field. Primary Contact Name:*This field is required. * Required Field. ABN (if applicable): Phone (mobile preferred):*This field is required. * Required Field. Residential/Business Address:*This field is required. * Required Field. Email Address:*This field is required. * Required Field.* Please enter a valid e-mail address. Website (if applicable): Are you a resident of the Midwest Region?*This field is required. YesNo Age Group:*This field is required. Under 18*18 years and over *If under 18: I provide consent for my child to apply for this opportunity. Parent Name: Artwork Details Name of Artwork 1:*This field is required. * Required Field. Artwork 1 Description:*This field is required. * Required Field. Upload Artwork 1*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Name of Artwork 2: (optional) Artwork 2 Description: (optional) Upload Artwork 2 (optional) Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Name of Artwork 3: (optional) Artwork 3 Description: (optional) Upload Artwork 3 (optional) Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Supporting Documents Please upload your CV Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Please upload up to 3 images of your previous work Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Additional image 2 Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Additional image 3 Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Terms and Conditions Terms and Conditions Click here to view the Terms and Conditions Have you read and accepted the Terms and Conditions*This field is required. Yes Type the code from the image: Do not fill this textbox. Save & Exit