Entry Form

Make a print of this page for each entry
Submit entry form and fee for each entry.
Artists may enter a maximum of two pieces per category.
Name ___________________________________________________________
Entry #________________ (for council use only)
Address ________________________________________________________
________________________________________________________
________________________________________________________
Phone __________________________
Category No. ______________ Media________________________________
Title ___________________________________________________________
Price (if for sale)_____________ Email address ________________________________________

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ARTIST'S COPY OF ENTRY FORM
To be attached securely to back of entry

Name ___________________________________________________________
Entry #________________ (for council use only)
Address ________________________________________________________
________________________________________________________
________________________________________________________
Phone __________________________
Category No. ______________ Media________________________________
Title ___________________________________________________________
Price (if for sale)_____________ Email address ________________________________________

Mail your entry forms, along with your entry fees to:
Lynn Thomas / 966 County Rte. 38 / Bainbridge, NY, 13733.

Checks may be made out to the Jericho Arts Council, Thank You

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