Visual Arts Consent Form Jury Date: Contact adviser or editor Please pick up a form from the English Department Room 2217 and submit before Jury. Student Eligibility and Guidelines: Open to all MDC students who are currently enrolled in any course at Kendall Campus. Entry form must be filled in its entirety. Attach this form to the back of the work. On the back of this form describe and title the work for identification purposes. Photos may be submitted along with this form, if the work(s) is larger than 8.5” x 11” If selected for publication, all works larger than 8.5” x 11” must be submitted on a 300 dpiquality CD. You will be contacted, via e-mail, concerning the exact room where the art will be juried. If you do not hear from an editor, contact Ricardo Pau-Llosa (rpaullos@mdc.edu) for it. Name: Mailing Address: Address City / State Zip Code Cell Other Telephone: Home Work E-Mail: Title of Work: If Art Work: Medium: Size of Original: Consent: If any work(s) submitted along with this form is selected for publication in Miambiance, I consent to first serial rights on my submission to be used in Miambiance Magazine. Rights return to me after publication. I attest that it is entirely my work and that I have been enrolled, in at least one (1) credit course, at Miami Dade College – Kendall Campus during the 200920010 academic years. I hold Miami Dade College harmless for the contents of my work(s). I understand that all submitted work may be used as illustration for the literature and that where the work is placed in the magazine is entirely determined by the editors.. Signature: Date: Bring this submission along with this form to: The Painting Studio, Kendall Campus on the assigned date, or take to: Miambiance Submissions Mailbox located at the English & Communications Department in room 2217. If you have any questions please contact: Professor Marta Magellan / Room 2218-01 / 305-237-2931 / marta.magellan@mdc.edu Professor Ricardo Pau-Llosa / Room 2217 / 305-237-2510 / rpaullos@mdc.edu