"YOUR CITY' EXHIBITION ENTRY FORM
Last Name
First Name
Email
Phone Number
Artwork #1 - Title of Work
Medium
Price
Size of Work
Artwork #2 -Title of Work
Medium
Price
Size of Work
preferred gallery attendance date (12/6 to 21/6)
*
-
Month
-
Day
Year
Time
preferred gallery attendance time 10.30am - 12.45pm, OR 12.45 - 3pm.
*
Hour Minutes
AM
PM
AM/PM Option
Method of Payment
*
EFTPOS on delivery
EFT to LAS - BSB 067003 A/C 28016820
I agree to abide by the conditions of entry
*
Submit
Should be Empty: