Artist: __________________________________

Address: ________________________________

_______________________________________

Phone: _________________________________

Email: __________________________________

Title of Artwork: __________________________

Medium: ___________________ Size: _________

Retail Price: ______________________________

Comments: _______________________________

________________________________________

________________________________________

ALL ARTWORK MUST BE RECEIVED ON OR BEFORE JANUARY 10TH 2008. PLEASE BE SURE AND ENCLOSE A CHECK TO COVER RETURN SHIPPING AND ANY INSURANCE COSTS IF NEEDED.

THE ARTIST IS RESPONSIBLE FOR HIS/HER ARTWORK TO AND FROM THE GALLERY.

DROP OFF YOUR ARTWORK ALONG WITH THIS FORM OR SEND IT TO:

G W BUSH C/O
JOE BUDDY'S
6504 SE FOSTER RD
PORTLAND, OR. 97206

Phone: (503)808-9228