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11/6/2007
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NARSAD ARTWORKS ART SUBMITTAL FORM I, ____________________ (artist please print), would like to submit the enclosed reproduction of my original artwork to be considered by NARSAD artworks for use in its products or for one time use in outside publications. I understand that only canon (or equal) color copies, 35mm slides or good quality photographs of my art are acceptable for submission and that they will not be returned unless I enclose a self addressed, stamped envelope. Please do not send original art. Submitted art will be reviewed by the art committee of NARSAD artworks on an as required basis. Art selected for use on artworks products will be chosen for its artistic merit, originality, freshness, positiveness and salability. I understand that my work may not be selected, but if it is I am willing to accept $250.00 per artwork as total compensation in the case of use in NARSAD Artworks products. For one time use of art we try to obtain $100 for the artist but that is negotiable and we will seek prior approval from the artist. I also understand that payment will be made at a maximum rate of $50.00 per month regardless of the number of works selected. If my work is selected, I understand that I will receive a formal contract restating the above and that I will be required to send NARSAD Artworks my original art. After processing, NARSAD Artworks will return my art but will have full, exclusive rights to its use for three years. After those three years, I may have non-exclusive rights to my art returned to me if I so request. NARSAD Artworks will exercise due diligence in protecting my art by copyright. ___________________________ Signature of artist Address____________________ ___________________________ ___________________________ _______________________________________ Sponsor (Healthcare provider. Affiliate member, etc.) Sponsor name __________________________ Phone: ________________________________ Artist phone: ___________________________ Date: _________________________________ SIZE OF ART WORK SUBMITTED: ____” X _____” MEDIUM: ________________ (if multiple submission, show size and medium of each on copy) (NOTE: NARSAD ARTWORKS IS NOT RESPONSIBLE FOR UNSOLICITED SUBMITTED ORIGINAL WORKS OF ART.) MAIL SUBMITTAL TO: NARSAD ARTWORKS P.O. BOX 941 LA HABRA, CA 90633-0941

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