ARTS COMMISSION: ARTIST REGISTRY FORM

ARTS COMMISSION: ARTIST REGISTRY FORM
If you are an artist living in Ivins, or with a studio/workspace in Ivins, or have gallery representation in Ivins, and would like to be listed in the Ivins Artist Registry, please complete this form on-line.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Ivins Address (Your address is needed to verify that you are an Ivins artist; it will not appear in the Artist Registry)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website
Medium*
Upload one image that best represents your current work

Cancelof
Include a brief description of your work or other important information relative to your work*
The Ivins Arts Commission may contact you via email or phone. Information provided on this form (other than address) may be included in the Ivins Artist Registry.
NOTE: If you are under 18 years of age, please have a parent/guardian sign this form:
Type a question
Parent/Guardian (please print name)
Parent/Guardian (Signature - type name)
Should be Empty: