Motif Collective Entry Form

"Landscape" Competition Submissions

Credit Card Entry Form

This Payment Form is hosted on SSL Servers that are both BAA (HIPAA) and PCI (DSS) level 1 compliant. Your credit card data is never transmitted processed or stored by any website or this secure form.
Full Name*

First NameLast Name
E-mail*
Website
Bio*
A short Bio (2-3 lines minimum) is required
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
After you select your number of entries the photo upload options will be available on the form.

Number of Entries and Payment Information*

4 Entries$20.00

5 Entries$20.00

6 Entries$20.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Each image submission should be appx 1200x900 in jpg format only and no larger than 1 Mb.

Please name your files in the format of the following examples:

Your Name: Jim Smith -

Image Name: Swampy Sunrise

eg. Jim Smith - Swampy Sunrise.jpg
Upload 1st Photo*

Upload

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Photo 1 Title - (Format: Your First and Last Name - Image Name)*
Upload 2nd Photo

Upload

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Photo 2 Title - (Format: Your First and Last Name - Image Name)
Upload 3rd Photo

Upload

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Photo 3 Title - (Format: Your First and Last Name - Image Name)
Upload 4th Photo

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Photo 4 Title - (Format: Your First and Last Name - Image Name)
Upload 5th Photo

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Photo 5 Title - (Format: Your First and Last Name - Image Name)
Upload 6th Photo

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Photo 6 Title - (Format: Your First and Last Name - Image Name)
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