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: ______________ -------------------------------------------------------------------------------------
MONIES ENCLOSED:

Competition Entry Fee: $30

TOTAL AMOUNT ENCLOSED: _________________