Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Check both boxes to submit your work. If both boxes are not checked we can not accept your submission. *

You are including your art work in this show at the Hamden Government Center at your own risk. By checking this box you agree to not hold liable the Hamden Arts Comission and/or the Town of Hamden should your art work be damaged or stolen while it is hanging in the show.

Your work will hang until it is sold, until you want it back or until we ask you to retrieve it. If you do not reclaim your work within one month of it being requested to be reclaimed, by checking this box, you acknowledge that your work will either be given away, donated, or disposed of.

Check here to acknowledge that no work will be accepted without a proper hanging device on the back OR without your name, phone number and email address PERMANENTLY affixed to it.

Date *

MM

DD

YYYY