12th Annual Photography 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: ____________________________________________
Price: ____________________________________________
Work #2:
Title: ____________________________________________
Price: ____________________________________________
Work #3:
Title: ____________________________________________
Price: ____________________________________________
Identification Labels:
Please fill out, detach, and affix to the back of your art.
Work #1:
Artist Name: ______________________________________
Address: _________________________________________
________________________________________________
Title: ____________________________________________
Price: ______________
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Work #2:
Artist Name: ______________________________________
Address: _________________________________________
________________________________________________
Title: ____________________________________________
Price: ______________
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Work #3:
Artist Name: ______________________________________
Address: _________________________________________
________________________________________________
Title: ____________________________________________
Price: ______________
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MONIES ENCLOSED:
Competition Entry Fee: $30
TOTAL AMOUNT ENCLOSED: _________________