Entry Form

Submission deadline: postmarked by Saturday, May 15, 2010

July 17 –September 18, 2010

Fill out the following and return with submissions. Include a check or money order made out to Coos Art Museum in the amount of $35.00 for up to 3 submissions. Send submissions, completed form and entry fee to: Coos Art Museum, 235 Anderson Avenue, Coos Bay, Oregon 97420. ATTN: Maritime

Artist’s Name:

Address:

City, State, Zip:

Email:

Telephone #:


ENTRY #: ____(Leave blank! Coos Art Museum to assign the Entry #)
Title of Work:______Medium: Size (including frame):

Accepted___________Rejected_______________



ENTRY #:____(Leave blank! Coos Art Museum to assign the Entry #)
Title of Work:________Medium Size (including frame):

Accepted___________Rejected_______________



ENTRY #:____(Leave blank! Coos Art Museum to assign the Entry #)
Title of Work:______Medium: Size (including frame):

Accepted___________Rejected_______________