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:


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

    This field is not part of the form submission.

38. Submit

* indicates a required field