asef creative networks

3rd EDITION - APPLICATION FORM

  • This application has to be submitted in English by email to y Saturday 15 August 2015.
  • Please save & send the completed form in PDF format and the file size is not larger than 1 MB.
  • Do not attach any files along with this form. All the information is to be filled within the form.
  • Projects should be proposed jointly by a minimum of 2 partners in Asia and Europe, with at least one partner from each region.
  • By submitting this application, you authorise and consent to sharing the records and information on ASEF’s website and online platforms andexpress interest in receiving future updates on ASEFopportunities.

Project Title

PARTNER 1

Name /
Address /
City /
Postal Code /
Country /
Website URL /
Please select Arts Discipline
- Cross-disciplinary/
Cross sectoral
- Visual Arts
- Film/Video/New Media
- Performing Arts
- Literature
- Critical Discourse
- Arts Management
- Technical Arts
- Others (Please specify) /

Head of organisation

Name /
Designation /

CONTACT person

Name /
Designation /
Email /

Complete phone numbers including Country Code and Area Code, e.g. +43 21 12345678

Mobile /
Office /
Home /
Fax /

PROFILE/Bio

Please fill in (maximum 200 words).

PARTNER 2

Name /
Address /
City /
Postal Code /
Country /
Website URL /
Please select Arts Discipline
- Cross-disciplinary/
Cross-sectoral
- Visual Arts
- Film/Video/New Media
- Performing Arts
- Literature
- Critical Discourse
- Arts Management
- Technical Arts
- Others (Please specify) /

Head of organisation

Name /
Designation /

CONTACT person

Name /
Designation /
Email /

Complete phone numbers including Country Code and Area Code, e.g. +43 21 12345678

Mobile /
Office /
Home /
Fax /

PROFILE/BIO

Please fill in (maximum 200 words).

OTHER PARTNER (IF APPLICABLE)

Name /
Address /
City /
Postal Code /
Country /
Website URL /
Please select Arts Discipline
- Cross-disciplinary/
Cross-sectoral
- Visual Arts
- Film/Video/New Media
- Performing Arts
- Literature
- Critical Discourse
- Arts Management
- Technical Arts
- Others (Please specify) /

Head of organisation

Name /
Designation /

CONTACT person

Name /
Designation /
Email /

Complete phone numbers including Country Code and Area Code, e.g. +432112345678

Mobile /
Office /
Home /
Fax /

PROFILE/Bio

Please fill in (maximum 200 words).

HUMAN RESOURCES

Please indicate number of staff to be working in this project

PARTNER 1 /
PARTNER 2 /
OTHER PARTNER(if applicable) /

WEB Links of previous projects (if any)

URL 1 /
URL 2 /

PROJECT PROPOSAL

Project Title /

BACKGROUND OF THIS JOINT PROPOSAL & PARTNERSHIP

Please fill in (maximum 200 words).

BRIEF DESCRIPTION OF THE PROJECT

Please fill in (maximum 200 words).

WHAT ARE THE ASIA-EUROPE PERSPECTIVES WITHIN THE PROPOSED PROJECT?

Please fill in (maximum 200 words).

PROJECT OBJECTIVES

Please state 2 main objectives of the initiative(maximum 100 wordseach).

Objective 1:

Objective 2:

Adopted format and reasons for choice

(e.g. research reports, publications, exhibitions, training workshops)

timeframe

Duration of entire initiative
From MM/YYYY To MM/YYYY /
Possible dates of the public events and venue
From DD/MM/YYYYTo DD/MM/YYYY /

PROJECTED OUTPUTS

Please list specific outputs of the project (such as number of trainings, publications)

OUTPUT 1 /
OUTPUT 2 /

TOTAL PROJECT BUDGET (in SINGAPORE DOLLARS/SGD)

EXPECTED FINANCIAL CONTRIBUTION FROM PARTNERS (in SINGAPORE DOLLARS/SGD)

PARTNER 1 /
PARTNER 2 /
OTHER PARTNER(if applicable) /

EXPECTED IN-KIND CONTRIBUTION FROM PARTNERS (YES/NO)

If the answer is YES, please indicate what in-kind support.

PARTNER 1 /
PARTNER 2 /
OTHER PARTNER(if applicable) /

EXPECTED FINANCIAL CONTRIBUTION FROM THE ASEF CREATIVE NETWORKS PRoGRAMME (in SINGAPORE DOLLARS/SGD)

Please note that the support will be a maximum of 50% of the total project cost with a maximum cap of SGD 25,000 for each project.

PAGE 1