Public Galleries Queensland

Application for:*

Volunteer Individual Bursary
Paid Staff Individual Bursary
Independent Curator Individual Bursary
Independent Artist Individual Bursary
Directors Circle Individual Bursary

Amount Requested*

for applicants registered for GST, this amount should be GST-EXCLUSIVE

Individual Applicant's Name*

Your organisation's name*

If you are an independent curator/artist you will be required to indicate your partner organisation here.

PGQ Membership Number (Institution)

Enter the membership number of your institution. If you are an independent curator/artist your partner organisation must be a current member of PGQ.

PGQ Membership Number (Individual)

Enter your individual membership number. If you do not know your membership number please contact the PGQ Membership Officer: membership@magsq.com.au or 07 3059 9745.

Your position/role*

Your contact number*

Your contact email*

Postal address for application correspondence*

Street Address Address Line 2 City State Post Code Country

Street Address

As above

Street Address

Street Address Address Line 2 City State Post Code Country

If successful, will the bursary be paid to:*

Your organisation
You (only available for Independent Artists/Curators)

Are you or your organisation registered for GST?*

Yes
No

Have you or your organisation previously received an PGQ bursary?*

Yes
No

If so, which year?*

Name of the Opportunity you are applying for*

Date/s of Opportunity

Start Date*

End Date*

Location of Opportunity*

How will the opportunity improve your contribution to your organisation and benefit the gallery/museum overall? (200 words)*

How will the knowledge and/or skills acquired/delivered during the activity be shared with the gallery/museum/sector? (200 words)*

Are you willing to share your experience with the wider gallery/museum sector in Queensland by speaking at a sector seminar or contributing to a blog on development opportunities, if requested by PGQ?*

Yes
No

If no, provide explanation

Breakdown of Costs

If the applicant is GST registered, PGQ will pay the bursary plus GST. Amounts in the Breakdown of Costs should exclude GST.

If the applicant is NOT registered for GST, amounts should include GST as this is part of the cost of the activity.

Income*

Source of Income	Amount

Please list grants or subsidies, other income, your contribution/your organisation's contribution, and amount requested from PGQ

Total Income*

Total Expenditure and Total Income must be equal

Expenditure*

Expenditure Item	Amount

Total Expenditure*

Total Expenditure and Total Income must be equal

Brief CV*

Max. file size: 2 MB.

Maximum 3 pages

Support letter from organisation

Max. file size: 2 MB.

CAPTCHA

Comments

This field is for validation purposes and should be left unchanged.

Bursary Application

Individual Bursary Form

Date/s of Opportunity

Breakdown of Costs