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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
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