11th Annual Miniature Show
Prairie Winds Art Center
Grand Island, Nebraska
ENTRY AND WORKSHOP REGISTRATION FORM
Payment must be included with this form

Print out form using the File - Print option on your computer. Information cannot be saved on this form.
Artist's Name: _____________________________________________________________________________________________

Address: _________________________________________________________________________________________________

City, State, ZIP Code: ________________________________________________________________________________________

Phone #: (_____) ___________________________ Email Address: ___________________________________________________

Signature: ________________________________________________________________________________________________
signature indicates acceptance of terms
Work #1:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #2:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #3:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #4:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #5:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________


Identification Labels:
Please fill out, detach, and affix to the back of your art.
Work #1:

Artist Name: ______________________________________

Address: _________________________________________

________________________________________________

Title: ____________________________________________

Price: ______________ Medium: ______________________
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Work #2:

Artist Name: ______________________________________

Address: _________________________________________

________________________________________________

Title: ____________________________________________

Price: ______________ Medium: ______________________
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Work #3:

Artist Name: ______________________________________

Address: _________________________________________

________________________________________________

Title: ____________________________________________

Price: ______________ Medium: ______________________
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Work #4:

Artist Name: ______________________________________

Address: _________________________________________

________________________________________________

Title: ____________________________________________

Price: ______________ Medium: ______________________
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Work #5:

Artist Name: ______________________________________

Address: _________________________________________

________________________________________________

Title: ____________________________________________

Price: ______________ Medium: ______________________
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To return to Miniature Show information page, please click here.
Workshop Registration:

April 9 - 11, 2010: ___

MONIES ENCLOSED:

Workshop Fees: $225

Competition Entry Fee: ____________

TOTAL AMOUNT ENCLOSED: _________________