STEP 2 of 3

ENTRY FORM

SHIRE OF MUNDARING OPEN ART ACQUISITION EXHIBITION 2016

Please complete the following entry form. If you have any questions please contact Clare Stroud on 08 9295 3991 or email cstroud@mundaringartscentre.com.au > 

 
1. CONTACT DETAILS
Name *
Name
2. TAXATION DETAILS
Australian Business Number (ABN) *
GST Status *
3. PAYMENT DETAILS
Preferred Method of Payment *
Bank:
BSB:
Account Number:
Account Name:
4. ARTWORK DETAILS
Artwork 1
Please Note: MAC will deduct a 35% commission from this amount
$
Please note: Up to 3 digital images per artwork must be sent to MAC by 5pm, 15 January 2016 (by post, digitally or in person)
ARTWORK 2 - If you would like to submit more than 1 artwork for consideration please complete artwork details below, otherwise continue to section 5. Agreement
Please Note: MAC will deduct a 35% commission from this amount
$
Please note: Up to 3 digital images per artwork must be sent to MAC by 5pm, 15 January 2016 (by post, digitally or in person)
ARTWORK 3 - If you would like to submit more than 2 artworks for consideration please complete artwork details below, otherwise continue to section 5. Agreement
Please Note: MAC will deduct a 35% commission from this amount
$
Please note: Up to 3 digital images per artwork must be sent to MAC by 5pm, 15 January 2016 (by post, digitally or in person)
5. Agreement