HIGH SCHOOL
DISTRICT JURIED ART EXHIBIT ENTRY FORM
# __________ (official use only)
Fill out completely and submit with delivery of work.
This form must be filled out electronically, handwritten forms will not be accepted
Name
Address
City
State
Zip Code
Email
Primary Phone Number
Grade: 9 10 11 12
School
*IF THE WORK IS NOT FOR SALE, CHECK THE N.F.S. BOX.
(YOU MUST STILL INDICATE A VALUE FOR INSURANCE PURPOSES.)
Entry A
Title
x
x
Medium
H”
W”
D”
* Value
N.F.S.
Entry B
Title
x
x
Medium
H”
W”
D”
* Value
N.F.S.
Entry C
Title
x
x
Medium
H”
W”
D”
* Value
N.F.S.
I understand that by checking the box marked “I Agree” and typing my name below, this constitutes a legal
signature confirming that I have read, acknowledge, and agree to the Juried Art Exhibit Prospectus Rules of Entry.
I Agree
First Name
Middle Initial
Last Name
Suffix
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Entry Tags
Fill out and attach securely to the BACK or BOTTOM of each entry.
HCC # _________________ (Official Use Only)
Entry A
Name:
Title:
Medium:
School:
* Value:
L
x
L
x
L
N.F. S.
H”
W”
D”
HCC # _________________ (Official Use Only)
Entry B
Name:
Title:
Medium:
School:
* Value:
L
x
L
x
L
N.F. S.
H”
W”
D”
HCC # _________________ (Official Use Only)
Entry C
Name:
Title:
Medium:
School:
* Value:
L
x
L
x
L
N.F. S.
H”
W”
D”
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