DUNGOG ARTS SOCIETY ANNUAL ART EXHIBITION -ENTRY FORM – SEPTEMBER 2015
PLEASE PRINT CLEARLY IN BLOCK LETTERS
and forward to Dungog Arts Society Inc. 96-102 Dowling St. Dungog, 2420 by 28th August 2015.
Title _____Surname _________________________ Given Name __________________________________
Street
__________________________________ Town
Postcode ____________
Home Phone _______________________________ Mobile/Business Phone __________________________
e-mail address _________________________________________
Are you a DAS Member- Yes ____ No____
Exhibit details (please print)
Sec
tion
Title of Work
Medium
Price
Size of Exhibit
in cm
Committee Use
only
Collect
Sold
ed
Do you need special display requirements (Sections 5 & 6) Yes ___No ___ If yes – please refer to the “Conditions of Entry”
Nos. 13 & 14 and attach details with this application.
Enclosed
________________
for $ ________________covering entry fee/s.
Cheque, money order, cash
I understand that: I am solely responsible for any GST liability on the sale of my work,
I agree to be bound by the conditions of entry,
and understand that section 3 (Local Artist Award) is aquisitive.
Signature
_______________________________________
Collected by ________________________________________
Date
____________________________
Date
____________________________
Please cut off the following labels, complete using block letters and stick 1 firmly to the back of each entry.
Please complete the following labels,printing in BLOCK LETTERS and attach one firmly to the back of each entry.
Exhibit Title _______________________________________________________
Price
_______________
Size & Medium (in cm.) ______________________________________________________________________________
Artists Name _______________________________________________________
Section ____________________
Exhibit Title _______________________________________________________
Price
_______________
Size & Medium (in cm.) _______________________________________________________________________________
Artists Name _______________________________________________________
Section ____________________
Exhibit Title _______________________________________________________
Price
_______________
Size & Medium (in cm.) _______________________________________________________________________________
Artists Name _______________________________________________________
Section ____________________
Exhibit Title _______________________________________________________
Price
_______________
Size & Medium (in cm.) _______________________________________________________________________________
Artists Name _______________________________________________________
Section ____________________