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Artist Interest Form

2. Personal Information
4. First Name
5. Last Name
7. Address1
9. Address2
11. City
12. State
13. Zip
15. Phone Number
16. Alternate Phone
18. E-Mail Address
19. NC Sales & Use Tax Number
21. Tell us about your work...
23. Short Biography or Artist Statement
25. Exhibit Space (check all that apply)

    1. Grand Lobby and Main Hall (two dimensional)
    2. Display Cases (three dimensional)
26. Are you interested in an art reception?

    1. Yes
    2. No
28. Media
30. Attach examples of your art work below
32. Example 1
33. Example 2
35. Example 3
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field