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APPLICATION
FORM 2010
You may print this page or download the PDF Application
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Winter Address (until April 15)
4107 SW Rushmore St.
Port St. Lucie, FL 34953
Ph. 772 879 1236 / Fx. 772 446 7671 |
Summer Address (after April 15)
P.O. Box 2751
Monatuk , NY 11954
Ph. 631 668 5336 / Fx. 631 668 0751 |
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Sponsored
by
MONTAUK ARTISTS ASSOCIATION, INC.
Not-for-Profit Tax Exempt
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APPLICATION
FORM 2010
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Return
this application form with 4-6 slides or photos
and your checks or Credit Card Information by MAY 15, 2010 to:
Montauk Artist's Association
P.O. Box 2751
Montauk, NY 11954-0300 |
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NAME_________________________________________________
ADDRESS______________________________________________
CITY - STATE - ZIP ______________________________________
HOME PHONE_____________________Fax ___________________
CELL PHONE___________________________________________
E-mail_________________________________________________
Web-site_______________________________________________
Vehicle License Plate #_______________________State_________ |
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| Oil/Acrylics____ |
| Watercolors____ |
| Mixed Media_____ |
| Pastels_____ |
| Graphics_____ |
| Digital Graphics_____ |
| Photography______ |
| Sculpture______ |
| Jewelry_____ |
| Ceramics_____ |
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PAYMENT:
I enclose my checks ___ or credit card for _____ spaces and my dinner _______
I wish to bring _____ guests @ $45 pp
TOTAL AMOUNT $________________
CREDIT CARD PAYMENT:
Discovery____ American Express _____ Mastercard ____ Visa ______
Card Number______________________________Exp_____/_____
CVV Security Number on back of card________
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ARTIST MUST SIGN WAIVER:
I will not hold the Montauk Artists' Association,
Inc. or the Town of East Hampton, NY responsible
for personal injury, loss or damage to art
entered in the show or of equipment used for
display. I agree not to be a part of any
legal action against the sponsors or the
committee of this show.
Date___________ Signature _________________________________________ |
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© 2004-2010
Montauk Artists' Association, Inc. All artwork is the property
of the individual artists.
For
information or comments on this site contact the webmaster
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