NYTW / 2050 Fellowship Application

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2050 Fellowship Application

First Name

Last Name

I am applying as a:

Director

Playwright

Email

Cell Phone Number

Other Phone Number (if applicable)

Street Address

City

State

Zip Code

Permanent Address:(if different)

Reference 1: Name & Contact Information

Reference 2: Name & Contact Information

I am:

A citizen of the U.S.

Not a citizen of the U.S.

If you are not a citizen of the U.S., please provide any
additional details about your residence and eligibility to work in the U.S.
here: [If awarded a 2050 Fellowship, you must a Taxpayer Identification Number
(TIN) as detailed on Form W-9, Department of the Treasury, Internal Revenue
Service in order to receive the Fellowship stipend..]

In a Single PDF please upload your Statement (750 Words) and Resume

Please read the following statement and initial in the provided text box as your agreement: If awarded the 2050 Fellowship, I will be available for a year-long commitment from June 2017 through June 2018, including, but not limited to, weekend retreats in June 2017 and 2018, attendance at monthly check-in meetings, and attendance at and participation in Fellows’ developmental readings to offer feedback and support for my colleagues’ work.

We’d love to know how you heard about the 2050 Fellowship at NYTW.

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