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KUALA KUALALUMPUR LUMPURDESIGN DESIGNWEEK WEEK2009 2009 INDEPENDENT DESIGNERS GROUP Application for Submission of Entry GROUP PARTICULARS NAME

YEAR ESTABLISHED

GROUP MEMBERS 1

2

3

4

5

Full Name (as per IC) Nickname (if any)

Identification No

Occupation

Date of Birth

Company/Institution

Gender

Email address

Contact No

Full Name (as per IC) Nickname (if any)

Identification No

Occupation

Date of Birth

Company/Institution

Gender

Email address

Contact No

Full Name (as per IC) Nickname (if any)

Identification No

Occupation

Date of Birth

Company/Institution

Gender

Email address

Contact No

Full Name (as per IC) Nickname (if any)

Identification No

Occupation

Date of Birth

Company/Institution

Gender

Email address

Contact No

Full Name (as per IC) Nickname (if any)

Identification No

Occupation

Date of Birth

Company/Institution

Gender

Email address

Contact No

*Note: Please print extra copies of this page for additional group members GROUP WEBSITE

http://

AREAS OF INTEREST Graphic

Animation

Product

Architecture

Videography

Furniture

Interior

Digital Art

Fashion

Photography

Soundscape

Mixed Media

Others (please specify)


GROUP HISTORY PREVIOUS EXHIBITIONS / PROJECTS Title of Exhibition / Project

Location / Specialization

Group/Individual (please specify who)

Month & Year

PREVIOUS ACHIEVEMENTS Title of Award / Publication

#

From

Group/Individual (please specify who)

Month & Year

PROJECT PARTICULARS TITLE

SPECIALIZATION Graphic

Animation

Product

Architecture

Videography

Furniture

Interior

Digital Art

Fashion

Photography

Soundscape

Mixed Media

Others (please specify) CONCEPT / INSPIRATION


PROJECT PARTICULARS (PART TWO) SPACE REQUIREMENT

PROPOSED LOCATION ALTERNATIVE LOCATION ITEMS / MATERIALS USED

PROJECT DESCRIPTION (in not more than 1000 words)

DECLARATION I hereby declare that all the information that have been given are true, together with the draft proposal of the exhibition / installation. Group Representative:

As witnessed by:

Name :

Name :

Date :

Date : FOR OFFICE USE

Received by

Date

Approved / Not approved

Reviewed by

Date

Allocated Space

Remarks


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