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APPENDIX A: Gallery Artwork Submission Inventory Form

Artist Name:

Mailing Address: 4134 Johnson st


City: High Point State: NC Zip code: 27265
Telephone Number:
336-4064397
Email:
glidon@yahoo.com
Please note the following: Title, Medium, Size, Price, Framed or Unframed

1. “Amazing Grace”-oil/canvas-30X40”-2,500.00

2. “All we are Maya”-oil/canvas-


3.“The Yesenia’s Lights”-oil/canvas-38X30”-2,500.00
4.

Artist’s Signature Signature of Gallery authorized representative

Delivery Sent Date Delivery Received Date

Carrier Company & Tracking Number

Casa Azul of Greensboro, Latitudes in Afro-Latinx Arts Series Exhibition Contract Agreement, 2023.

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