ENTRY FORM Cancer Fund Fundraiser

Fundraiser OCTOBER 21ST

ENTRY FORM DUE: October 7th, 2011
Sharon Dowis 715-297-4779 - slddartifacts@dwave.net
Chandra Witter 715-297-0858 - chandralyn@gmail.com
NAME_________________________________ DAYTIME #_____________________________
ADDRESS______________________________CELL #_________________________________
STATE/ZIP_____________________________EMAIL__________________________________
ALL INFORMATION IS TO BE FILLED OUT COMPLETELY BY THE ARTIST. PLEASE PRINT
CLEARLY!

ITEMS TO BE DONATED FOR THE EVENT (NOT CURRENTLY ON

DISPLAY):
Title, Medium, Price, Percent Donated
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__________
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ART CURRENTLY ON DISPLAY IN COLORAMA
Title, Medium, Price, Percent donated over the 25% that the guild is
donating
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WVAG

607 s. 24th Ave, #147

Wausau, WI 54401