EQUINE ART CALENDAR COMPETITION ENTRY FORM

To submit your entry for our calendar competition, complete this form and enclose your slide/photo or JPG on CD along with payment to American Academy of Equine Art, Inc. and mail to:
Nancy Pellatt
1293 Guerins Bridge Road, Awendaw, SC 29429
843-216-5341
nancypellattart@juno.com

(Please Print or Type)

Name: __________________________________________

Address: ________________________________________

City: ___________________________________________

State: ___________________________ Zip: ___________

Telephone: (day) __________________________________

Telephone: (evening) ______________________________

Fax: ___________________________________________

E-mail: _________________________________________


(   ) This is my first entry. ($25)       (   ) I have already entered the contest this year. ($10)


Entry Information:

Title of Work _____________________________________ Medium_____________________

Unframed Size _____________________________________

 

Payment enclosed in the amount of $ ________

Form of Payment: check VISA M/C

Card #___________________________________________

Exp. Date:_____________________ Numbers on back of Card:_______________

Name as it appears on card:___________________________________________