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Application – Trash to Treasure Collection  –  Portable Art Kiosks

Name_____________________________ Date ______________

Address           _________________________________________________



Phone(1) __________________   Phone(2) ___________________

Pay Pal email or associated phone number for stipend payment__________________________________________

Email  _________________________________________________

Website and other social media _____________________________________________________

Tell us more about yourself:

Social Justice Topic:  _________________

Art Work Statement example:


How is your work sustainable?:


Explain why you would like to participate in this ACW sustainable kiosks:


Are you interested in sitting table events?:

Art to Change the World is looking for artists that can produce art and items to be placed in Art to Change the World’s sustainable kiosks. If you have more than one item you’d like to submit, please copy and paste this section for each item.

Item Title______________________________________________

Item Price________________________________________

Item Description__________________________________________

Quantity can make________________________________________

Date can make items by_____________________________________

Please describe your reproduction plan if requested to make more items for the kiosk:


Please send high resolution image  JPEGs, not exceeding 10MB. Title JPEGs as follows:


By Signing below, I acknowledge that the information contained within accurately represents the proposal being submitted. I have read, and understand, the requirements for all artists participating. If Accepted, I will attend required trainings to be a participating artist.


Signature ____________________________ Date ________________

Return Resume and application to:


Office Use

_____ Date of ACW Membership.  _____ Initials _____ Date Rcd

_____ Jury Date ______ Final Status _______ Notification Date