Entry Forms, Gallery 202, Arts Westerville
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Entry Form

You may make a direct entry payment using Paypal - "Make a Donation" - button and please fill out the information below to secure your entry spot:

or mail payment to: Gallery 202, Partners in Art,Inc.
PO Box 1545
Westerville, Ohio 43086

For Inkind Donations, please list

or use the donation button to make a donation to Gallery 202, Partners in Art, Inc. programs/events.

This will hold your entry spot until we receive payment. Thank you!

*=Required



Name

Email*

Address:

City:

State:

Zip:

Phone:

Fax

Web Page

Category:Chair
Bench Art

Level:Student, Artist/Patron

Entry Fee: Due 4/3/05: Chair Due 6/17/05: $5 Student/chair, $10 Adult/chair

Bench - Fee: TBA

If this is a group project, please list all names:

Describe Your Artwork - medium, size, imagery etc

After submitting this form, please hit backspace to use Pay Pal services or mail in your entry fee with form.

If you dislike Form Mail, drop me a line at

webmaster

or mail your donation/questions to PO Box 1545, Westerville, Ohio 43086