Proposal for Temporary Public Art Summit Public Art Summit, New Jersey firstname.lastname@example.org About the ArtistName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail* Artist’s website URL:About the ArtworkOwner of work (if not artist):Title of artwork:One-sentence description of the artwork:Year created:# in edition:Description of artwork (measurements, weight, materials, etc):Dimensions (H x W x D):Weight of the work:Materials used:Value of the artwork: NOTE: If the value of the artwork exceeds $25,000, please check one of the boxes below I have attached an independent professional appraisal to substantiate the stated value shown above. I will obtain an independent professional appraisal at my own cost and submit it prior to final approval. I have attached evidence that I carry insurance on the artwork that will cover any damages or claims in lieu of insurance by the city. Installation DetailsDoes the work require a concrete or other solid base?*YesNoIf YES, how is the work mounted to the base?*Does the work require an electrical connection?YesNoDoes the work require a crane or other overhead device for installation?YesNoIs any part of the work flammable?YesNoDoes the work have any sharp edges or pointed elements that limit its installation in areas used by small children?YesNoDescribe in detail the method for installing and de-installing the artwork:Supporting MaterialsArtist’s résumé or CV, including information and details about educational background, previous work, gallery showings, and past experience in public art exhibits.Artist’s Statement conveying your vision as an artist and your body of work in 150 words or less.Project Description highlighting your creative intentions, including how your artwork fits into the Summit Public Art program.Digital images of proposed artwork, as well as 3 to 5 images of past work in jpeg format. Include an associated image list including title, date of completion, medium, dimensions, and location. Each image should be no larger than 500 MB, with the total digital presentation not to exceed 1 GB. Drop files here or PhoneThis field is for validation purposes and should be left unchanged.