Mail-In Entry Form

Celebrating Women's Work - An All Media Group Exhibition

On View: March 8th - March 25th, 2012

Entry Deadline: Feb. 27th 2012, Removal of Works: March 25th, 5-6pm, and March 26th 10am-2pm

Print, Complete and Mail Form with Payment of Entry Fee to:The Pen and Brush, Inc.
16 East 10th St.New York, NY 10003

Please Check One: Member: ($35.)______ Non-Member Past Participant : ($50.)________

Non-Members Enter title of previous show you entered and/or exhibited in: ______________________________________

Name______________________________________________________________________

Address________________________________________________________________________________________

Phone_________________________________Email_____________________________________________________
Please note The Pen and Brush will use email as the primary form of notification unless other preference noted.

Check Enclosed ________ or Credit Card___________________________________________Exp.______________

Members can exhibit up to 3 works / Non-Member Past Participants can exhibit up to 2 works

1) Title ____________________________________________

Size/Length/Run Time: ___________Medium___________Price_______

2) Title ____________________________________________

Size/Length/Run Time___________Medium___________Price_______

3) Title ____________________________________________

Size/Length/Run Time___________Medium___________Price_______

Click here to read our User Agreement & Liability and Copyright Provisions. Your submission indicates you hereby agree to the liability clause and to abide by all rules and conditions set forth in our User Agreement & Liability and Copyright Provisions.

I hereby agree to the liability clause and to abide by all rules and conditions set forth in
the Pen and Brush User Agreement viewable at www.penandbrush.org

Artist’s Signature____________________________________________________Date_______________