ART QUILTS LOWELL 2014 CONFIRMATION/INVOICE

Please:

1. print this document out
2. check it for accuracy, make any corrections and initial. Different parts of the information below will be used for insurance forms, gallery labels, contacting you about questions/issues, publicity, etc, so please make sure it is accurate.
3. indicate whether you will be hand-delivering or shipping your work. If shipping...
   • you MUST use either UPS or FedEx. Do NOT use the postal service!
   • you MUST provide a pre-paid, bar-coded shipping label. Without it we cannot return unsold work.
   • we CANNOT accept personal checks, stamps or cash. We can ONLY accept UPS or FedEx pre-paid, bar-coded shipping labels
4. Enclose your entry fee check for $25.00 for up-to-date Brush Members $35.00 for non-members. Not sure if you are an up-to-date member? Click HERE. Not a member and want to become one? Click HERE.
5. Send this document plus your entry fee check to:
   The Brush Art Gallery & Studios
   256 Market Street
   Lowell, MA 01852

Check one:

__ I will be hand-delivering my work

__ I will be shipping my work

FName :              #FName#
LName :              #LName#
Street :               #Street#
City :                  #City#
State Prov :         #StateProv#
Zip PCode :         #ZipPCode#
Phone Number :   #PhoneNumber#
EMail :                #EMail#

Title1 :               #Title1#
Materials1 :         #Materials1#
Dimensions1 :      #Dimensions1#
Insurance Value1 :#InsuranceValue1#
Selling Price1 :     #SellingPrice1#

Title2 :               #Title2#
Materials2 :         #Materials2#
Dimensions2 :      #Dimensions2#
Insurance Value2 :#InsuranceValue2#
Selling Price2 :     #SellingPrice2#

Title3 :               #Title3#
Materials3 :         #Materials3#
Dimensions3 :      #Dimensions3#
Insurance Value3 :#InsuranceValue3#
Selling Price3 :     #SellingPrice3#