the village gallery & Studio

 Artist's Name:     _________________________________________________________________________________________________________________



Address:

_________________________________________________________________________________________________________________



Phone:

_________________________________________________________________________________________________________________



Email:

_________________________________________________________________________________________________________________



Signature:

_________________________________________________________________________________________________________________







               Entry #1                                                                 Entry #2


Title:______________________________________________________     Title:______________________________________________________


Medium:________________________________________________      Medium:________________________________________________


Framed Size:___________________________________________      Framed Size:__________________________________________


Price:_____________________________________________________      Price:_____________________________________________________


Artist Name:___________________________________________      Artist Name:__________________________________________


Phone:___________________________________________________      Phone:___________________________________________________



The Village Gallery Registration Form