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ENTRY FORM Name Naul Ojeda
Address 1730 Church St NW Washington, DC 20036
Telephone Day 483-6311
Evening 483-6311

I have read and accept the terms of the AGREEMENT printed on the reverse of this form, and affirm that I meet the eligibility requirements stated in the PRINTS: WASHINGTON exhibition announcement.

If I am unable to pick up my print on the date specified in the schedule of the exhibition announcement, I designate Pennie Ojeda to do so for me.  

Description of print entered:
Title Homenaje a Rod[[strikethrough]]e[[/strikthrough]]rigo (A/P)

Medium (Be specific about techniques used.)
woodblock print, handprinted on Hosho rice paper, edition 15

Dimensions of plate or image, in inches, height and width 62X36
Date created 1986
Value for insurance purposes $1,500

Signature
Date March 15

RECEIPT FORM (Send with entry form.)

The following print has been received for jurying for the PRINTS: WASHINGTON exhibition:

Artist's name
Title of print
Medium
Dimensions
Recipient's signature

LABEL (Do not send with entry form.)
Artist's name
Title of print
Dimensions of plate or image, in inches, height and width
Medium
Date created
Artist's telephone Day
Evening