ENTRY FORM __Oil.. __Aquamedia __Graphics__ Pastels __ Sculpture Describe Medium______________________________________________Description of Materials_______________________________________ ARTIST (LAST)______________________________(FIRST)_____________________ ___Member ___ Associate ___Honorary ___ Non-Member ADDRESS______________________________________________________________ CITY________________________ STATE ________ ZIP ________________________ TELEPHONE ( ______ ) _______________________E-MAIL______________________ TITLE ______________________________________________________________ SIZE _____________________________________ PRICE ____________________ I hereby agree to accept all terms and conditions set forth in this prospectus Artist's Signature _____________________________________ |
EXHIBITION LABEL: ACCEPTED WORK ......Accepted please remit $35 installation fee to Medium Director .…..Declined ARTIST____________________________________________________________ ADDRESS_________________________________________________________ CITY_______________________________STATE_________ZIP_____________ TELEPHONE_______________________________________________________ MEDIUM________________________________PRICE_____________________ AGENT____________________________________________________________ AGENT ADDRESS______________________________________________________ |