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Artist:  (First Name)
(Last Name)
Artist 2:  (First Name)
(Last Name)
Address: 
City:  ,  State:    Zip: 
Email Address:  Phone:  (xxx-xxx-xxxx)
Will be listed in program
Business Name: 
Website: 
Make & License of Vehicle:  (Make)  

 (License Plate)
Medium: Metal (Non-Jewelry) Wood Furniture Other 
  Ceramics Photography Jewelry Oil Paint & Oil Style Acrylic Paint
  Prints, Drawings, Pastels Mixed Media Fiber/Wearable Art & Basketry
  Glass (non-jewelry) Water Media Sculpture (non-metal)
In 5 words or less, describe your art for our program: 
 
 I will be bringing a large rig/trailer (larger than a van).
 I shall require a space with handicap access.
 I will be using a low emission, low noise generator, located on an edge of booth space where it will not disturb other artists.
 Check box if you want your slides entered in poster contest (indicate on slides which are to be considered).
 



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