Art Exhibition Entry Form – Patrick Speech and Languages Centre

CONTACT INFORMATION:

Artist Full Name:

Gender

Male Female

Age

Phone Number:

Alternate Number:

Residential Address:

GUARDIAN PROFILE:

Full Name

Phone Number

Email Address

Residential Address

BRIEF PROFILE OF THE ARTIST:

How long has he/she been painting?

How many Art work does he or she have?

TERMS AND CONDITIONS:
(a) The Art work must be well framed and in good presentation condition
(b) There must be a 30-70% sharing formula

I declare that all information provided in this application is true and accurate at the time of submission. I grant permission to the organisers or organisation to use/display my artistic works or tapestries.

Name

Date