Wisconsin Visual Artists’ Guild

ENTRY FORM “REACHING NEW HEIGHTS”

“SUMMER RETREAT” June 7th - September 6th, 2011
ENTRY FORM DUE: MAY 27TH, 2011
Sharon Dowis 715-297-4779 - slddartifacts@dwave.net
Chandra Witter 715-297-0858 - chandralyn@gmail.com

NAME_________________________________ PHONE ____________________

ADDRESS_____________________________ EMAIL ______________________

Print Legibly
STATE/ZIP_____________________________CELL PHONE______________
ALL INFORMATION IS TO BE FILLED OUT COMPLETELY BY THE ARTIST. PLEASE PRINT CLEARLY!

1ST CHOICE TITLE_________________________________________________

MEDIUM_______________________PRICE (WVAG RETAINS 25%)___________

DIMENSIONS (WIDTH X HEIGHT X DEPTH OVERALL)____________________________

2ND CHOICE TITLE_________________________________________________

MEDIUM_______________________PRICE (WVAG RETAINS 25%)___________

DIMENSIONS (WIDTH X HEIGHT X DEPTH OVERALL)____________________________

3RD CHOICE TITLE_________________________________________________

MEDIUM_______________________PRICE (WVAG RETAINS 25%)___________

DIMENSIONS (WIDTH X HEIGHT X DEPTH OVERALL)____________________________

SIGNATURE______________________________________________________
Your signature indicates acceptance of all conditions in this prospectus and is REQUIRED.
Your signature constitutes an agreement for Wisconsin Visual Artists’ Guild/Marshfield Clinic-Weston
Center to reproduce artwork for catalog, publicity, website and/or educational purposes.

CHECKLIST: SEND ENTRY FORMS TO:

O Artistic Statements Attached and Labeled
O Fully Completed Entry Form SUMMER RETREAT 2011
O Signature – A MUST! C/O WVAG
O Non-Refundable Personal Check/Money Order 607 S. 24th Ave., Box 147
Payable to WVAG Wausau, WI 54401
For: $35 for up to 3 pieces entered
$5 each additional piece, up to 6 total entries Revised 1-11-11

DELIVER ART TUESDAY, June 7th FROM 4 – 6 pm TO THE CLINIC