9th Annual Regional Miniature Art Show
Prairie Winds Art Center
Grand Island, Nebraska
ENTRY FORM
Payment must be included with this form

Print out form using the File - Print option on your computer. Information cannot be saved on this form.
Artist's Name: _____________________________________________________________________________________________

Address: _________________________________________________________________________________________________

City, State, ZIP Code: ________________________________________________________________________________________

Phone #: (_____) ___________________________ Email Address: ___________________________________________________

Signature: ________________________________________________________________________________________________
signature indicates acceptance of terms
Work #1:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #2:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #3:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #4:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________

Work #5:

Title: ____________________________________________

Medium: _________________________________________

Price: ____________________________________________
Identification Labels:
Please fill out, detach, and affix to the back of your art.
Work #1:

Title: ____________________________________________

Medium: ________________Price: ____________________

Artist's Name: _____________________________________
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Work #2:

Title: ____________________________________________

Medium:____________ Price: __________________

Artist's Name: _____________________________________
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Work #3:

Title: ____________________________________________

Medium: ______________Price: ______________________

Artist's Name: _____________________________________
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Work #4:

Title: ____________________________________________

Medium: _______________Price: _____________________

Artist's Name: _____________________________________
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Work #5:

Title: ____________________________________________

Medium: _________________Price: ___________________

Artist's Name: _____________________________________
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