Application Form

Name (please print):

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Address (where your check should be mailed):

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Telephone and e-mail:

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Age?

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Type of artwork:

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How much display space would you like?

One panel ______Two panels ______Other:______

May we link to your website? If so, please give us the link:

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Signature:

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Please mail this form and $25 registration fee to 
Rose Algrant Art Show, PO Box 234, West Cornwall, CT  06796