Bluemont Fair
                                Art Show & Sale


Please complete and sign this form.

Artist’s Name _______________________________________________________________



Title #1 ____________________________________________________________________

Medium ____________________________________________________________________

Price _______________________  Dimensions ___________________________________



Title #2 ____________________________________________________________________

Medium ____________________________________________________________________

Price _______________________  Dimensions ___________________________________



Title #3 ____________________________________________________________________

Medium ____________________________________________________________________

Price _______________________  Dimensions ___________________________________



Title #4 ____________________________________________________________________

Medium ____________________________________________________________________

Price _______________________  Dimensions ___________________________________



Title #5 ____________________________________________________________________

Medium ____________________________________________________________________

Price _______________________  Dimensions ___________________________________



Signature:  _____________________________________________   Date:____________


Name:  ______________________________________________________________________

Address:  ___________________________________________________________________

Phone:  _____________________________________________________________________