free web site creator

Wallace Stegner House application form.

Application form can be downloaded or printed here:

Application.doc or: Application.pdf

Name _____________________________________
E-mail _____________________________________

1. Name____________________________________
E-Mail _____________________________________

2. Name____________________________________
E-Mail _____________________________________

Preferred Dates for Residency
Start Date End Date
First choice _________________________________
Second choice ______________________________
Third choice ________________________________

Professional Information
1. Please tell us about yourself and your work. (Fewer than 300 words)
2. List your major works published, performed or shown by title, discipline and date.
3. List any awards applicable.
4. List any professional development you have taken part in (courses, classes, workshops)
5. What will you be working on while at the Wallace Stegner House? (Fewer than 300 words)
6. Will you allow your name to appear on our Website Residency Calendar?
7. Please tell us how you heard about the Stegner House. 

Payment: ($250 per month)
Full non-refundable payment is due within 2 weeks of your acceptance of the residency offered.

We offer no stipends for the regular 11 month resident calendar.