artsnb - Applicant Registration

* mandatory fields

Applicant Information

Last name: *

First name: *

Pronouns:

Please select the option(s) that reflect your pronouns.

She / Her
He / Him
They / Them
Other, please specify:

Email address: *

Preferred language: *

English
Français

Join the mailing list? *

Yes
No

Make sure you receive information on program deadlines, workshop opportunities, new programs, residencies, calls and competition deadlines, and relevant information sharing from us and our partners.

Primary phone number: * - -

Secondary phone number: - -

Fax number: - -

Website:

Citizenship Status: *

Canadian Citizen
Permanent Resident

First Nation Affiliation:

Mig'Mag
Wolastoqiyik / Maliseet
Passamaquoddy
Other :

Canadian permanent resident since (date):

immDate_month immDate_day immDate_year

Permanent resident of NB since (date):

resDate_month resDate_day resDate_year

Permanent Address

Street address: *

Street address 2:

City: *

Province: *

Postal Code/Zip Code: * -

Mailing Address

Only if different from above address

Street address:

Street address 2:

City:

Province:

Postal Code/Zip Code: -

Create a Password

Enter Password: *

Please create a password that is a minimum of 8 characters, contains an uppercase letter, a lowercase letter, one number, and one special character.

Confirm Password: *