|
Name
of
Entrant_______________________________________________________
|
|
Address
_____________________________City/State/Zip_____________________
|
Phones______________________________________________________________
|
Name
of
Artist_________________________________________________________
|
Title
of
Piece__________________________________________________________
|
Medium______________________________________________________________
|
Value________________________________________________________________
|
Is the Piece For
Sale
Yes_________
No___________ |
I
agree to allow the Longview Museum of Fine Arts
to exhibit this piece, and if chosen, will allow
it to remain in the LMFA galleries from today's
date _______________through Monday, August
29. This piece has not been shown in the
Museum before.
|
Signed
|
_____________________________________ |
| |
