MONOCHROME
 ONLINE ENTRY FORM


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Your name:

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Where did you learn about this opportunity?:

Status: (select one)

Number of Entries:

(If submitting more than 12, return to this page to complete the additional entries)

Entry fee total (number of works x $10):

I will mail entry fee (send to: Manifest Gallery, MONOCHROME, P.O. Box 6218, Cincinnati, Ohio 45206)
I prefer to use paypal (a link to paypal will be provided upon submission of this form)

I will be submitting my entries by:


attachment (send to show@manifestgallery.org)

ENTRY 1 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):
Insurance Value:

Notes: (include framed dimensions if applicable)

ENTRY 2 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 3 ($10 fee)

Title:
Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:

Notes: (include framed dimensions if applicable)

ENTRY 4 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 5 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 6 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 7 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 8 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 9 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 10 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 11 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

ENTRY 12 ($10 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (actual artwork only)

Date:

Sale Price (or NFS):

Insurance Value:


Notes: (include framed dimensions if applicable)

 

Double check the information you entered above. Clicking SUBMIT indicates that you agree with the conditions of entry and exhibit as outlined in the prospectus, and that you agree to make your work available should it be selected for exhibit.

(A copy of your entry will be automatically sent to the e-mail address you provided.
Please print and retain the e-mail for future reference. If you do not receive this email right away, please check your spam box.)