PLEASE PRINT CLEARLY -- MAKE SURE TO READ AND FOLLOW ALL INSTRUCTIONS IN PROSPECTUS
Artist’s name:_________________________________________
Home address:_________________________________________________
City___________________State____________________ Zip_______________
Home phone ( )_______________________________
E-mail:_________________________________________________________
NAEA Membership #: _______________________________
Institution: _________________________________________
Teaching Position:_________________________Fax #:___________________
Entry # 1
Title:____________________________________________________________
Media:____________________________________
Entry # 2
Title:____________________________________________________________
Media:____________________________________
Entry # 3
Title:____________________________________________________________
Media:____________________________________
*Make a copy of this application for your records. Entries without membership number & this complete entry form, will be rejected & forfeit entry fee. Sticker labels, unmasked slides or slides masked with tapes other than slide tape will be rejected and forfeit entry fee. Do not send resume or statement with entry. Please allow 4 weeks after the end of exhibit for the return of slides.
AGREEMENT: Submission of an entry constitutes permission to photograph it for publicity and educational purposes. Every precaution will be taken to prevent damage or loss of slides but NAEA/The Electronic Gallery assumes no liability in the case of mishap. You may want to insure your slides while in transit. Submission of work to this competition constitutes acceptance of all conditions referred to in this prospectus.
Artist’s signature_____________________________________________________________