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ENTRY FORM Name Address Telephone Day Evening 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 ... to do so for me. Description of print entered: Title 2/25 Lunch time Medium (Be specific about techniques used.) woodcut, handprinted on Hosho rice paper, edition of 25 Dimensions of plate or image, in inches, height and width 22X12 Date created Value for insurance purposes $150 Signature Date 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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