SAFEhouse for the Performing Arts Registration Form

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ARTISTS PLEASE NOTE: At this time, YOU ARE REQUIRED TO SUBMIT THIS FORM FOR EACH TIME YOU PARTICIPATE IN A SAFEhouse PROGRAM (that includes repeat residents, festivals, studio rentals, etc. - you MUST submit a new form for EACH)!

I am filling out this form to: *

Apply for RAW Residency

Apply for RAW Teacher's Residency

Rent SAFEhouse Arts or Co-produce a Show

Other:

First Name *

Last Name *

Company Name

(if different from above name)

Title

(optional - e.g. Artistic Director)

Mailing Address *

Email Address *

Current City

Phone Number *

e.g. 555-555-5555

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