entry form by TkoK45V

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									               Harrison Art Show
                                            Entry Form
Please complete and return to Harrison School no later than Friday June 22nd, 2012.
Harrison Art Show, Harrison School Community Association, Wimmera Street, Harrison, ACT 2914 or
email to: harrisonartshow@hotmail.com
Please deliver your works to the Performing Arts Centre, Harrison School (Cnr Wimmera St and
Nullarbor Ave) on Wednesday 27th between 4pm and 6 pm.

Name:                                                                     ABN:

Address:

Phone:                                                 Mobile:

Email:

Art Works to be entered
Number         Title or description                              Medium          Size   Sale Price
(office use)




Proceeds and unsold works to be collected from the Harrison School Performing Arts Centre on
Sunday 1st July, between 3pm and 5pm.

If you wish to enter more than five pieces, please contact the organisers at
harrisonartshow@hotmail.com.




|1                                    www.harrisonartshow.weebly.com
Please complete below if you wish for someone to act on your behalf.

I, …………………………………………………………. hereby authorise …………………………………………………………… to
   (Artist)                                              (Authorised Person)
             Deliver works to Harrison School on Wednesday 27th June
             Collect unsold pieces and/ or proceeds on Sunday 1st July

Signed: ………………………………………………………..                      ………………………………………………………………..
        (Artist)                                       (Authorised Person)




Payment details (per piece):
A5 (210x148mm) or smaller:      $5.00
Larger than A5:                 $10.00
Please pay by either Direct Deposit, or credit card (MasterCard or VISA)

Direct deposit details (Please reference “Art (yoursurname)” for identification purposes):
Bank: Westpac Gungahlin
BSB: 032 733
Account: 105 658
Name: Harrison School Community Association Incorporated

Receipt number: …………………………………………………………………..

Date of payment: ……………………../…………………./…………………




Credit Card details:
 MasterCard             VISA



Card number

Name on card: ……………………………………………………………………… Expiry:
                                                                           MM            YY




|2                               www.harrisonartshow.weebly.com
                                          Office use only
Number   Delivered   Sold      Returned      Deposit        Full payment   Purchaser details




|3                          www.harrisonartshow.weebly.com

								
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