Spring Into Art Entry Form
Print a copy of this form and submit it along with a photo of
your entry by Wednesday, February 18th. (Up to 5 entries may
be submitted: please fill out an entry form for each submission):
| E-mail Address: | 4jfaye@sbcglobal.net | |
| Mailing Address: | Janice Molnar | |
| 210 Meigs Ave | ||
| Jeffersonville, IN 47130 |
|
Questions? Call Janice Molnar at 812-282-2151
or Norma Jenkins 812-282-9189. |
Name of Artist: ________________________________________
Address: ___________________________________________________
City, State, Zip: ____________________________________________
Home Phone Number: _______________ Cell or work: ________________
E-Mail: ________________________________
Check age category: Adult (over 18)___ Teen (13-16)___ Child (age 12 or less)___
Entry Description: ___________________________________________________
__________________________________________________________________
Title: _______________________________________________________________
Medium: _________________________
2-D:____ 3-D____ Framed Size (WxH): __________________
Approximate Weight(Lbs): _________________
Year Completed: __________ Price/NFS: ______________
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The Following box is for Administrative Use Only. (Do not fill in.)
Entry #______________
Date Received: ___________ Artist Initials _________ HSM Initials __________
Date Received: ___________ Artist Initials _________ HSM Initials __________