12th 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:
May 7, 2011: ___
MONIES ENCLOSED:
Workshop Fees: $65
Competition Entry Fee: ____________
TOTAL AMOUNT ENCLOSED: _________________