Entry Form (Please print neatly, and print out and attach to rear of artwork)

Name:___________________________________________________________

Address:_______________________________________________

City/State/Zip____________________________________________________________

Email__________________________________________________________________

Phone____________________________________________________________________

Title of work______________________________________________________________

Dimensions:___________________________________________________

Price__________________________or NFS______________

I____________________________________________ understand that PVCC, and the Maricopa Community College District will not be responsible in the event of theft or damage to my artwork while in the possession of the Fine & Performing Arts Division faculty and staff.

Signature___________________________________________Date______________________________