PASEGURUHAN NG MGA NAGLILINGKOD SA PAMAHALAAN

(GOVERNMENT SERVICE INSURANCE SYSTEM)

Financial Center, Pasay City, Metro Manila 1308
19th GSIS NATIONAL ART COMPETITION 2024
RETRIEVAL FORM
GSIS COPY

ENTRY NO.: ____________ DATE: ____________

CATEGORY: ________________________

ARTIST’S NAME: ____________________________________ EMAIL ADDRESS________________________

ADDRESS: ____________________________________________________________________________________

CONTACT NO: _________________________________________ TIN NO.: ______________________________

TITLE OF WORK: _____________________________________________________________________________

MEDIUM: ______________________________________________SIZED/DIMENSION: ___________________

PRICE (If the artwork is for sale): __________________________ YEAR: _______________________________

RETRIEVED BY: APPROVED BY:

___________________________________ _____________________________________
Signature over printed name GSIS Museum Staff

Note: Retrieval of entry/entries is from November 4, 2024 to December 14, 2024. UNCLAIMED
ARTWORKS after this date will be disposed of by the GSIS Museum accordingly.

-------------------------------------------------------------------

PASEGURUHAN NG MGA NAGLILINGKOD SA PAMAHALAAN

(GOVERNMENT SERVICE INSURANCE SYSTEM)
Financial Center, Pasay City, Metro Manila 1308
19th GSIS NATIONAL ART COMPETITION 2024
RETRIEVAL FORM
ARTIST COPY

ENTRY NO.: ____________ DATE: ____________

CATEGORY: ________________________

ARTIST’S NAME: ____________________________________ EMAIL ADDRESS________________________

ADDRESS: ____________________________________________________________________________________

CONTACT NO: _________________________________________ TIN NO.: ______________________________

TITLE OF WORK: _____________________________________________________________________________

MEDIUM: ______________________________________________SIZED/DIMENSION: ___________________

PRICE (If the artwork is for sale): __________________________ YEAR: _______________________________

RETRIEVED BY: APPROVED BY:

___________________________________ _____________________________________
Signature over printed name GSIS Museum Staff

Note: Retrieval of entry/entries is from November 4, 2024 to December 14, 2024. UNCLAIMED
ARTWORKS after this date will be disposed of by the GSIS Museum accordingly.