YEAR JOINED APS (only open to Current APS members who joined after 1/1/15) *

Name *

First

Last

Phone number (include area code) *

Email *

PAINTING A___Title *

Painting A___unframed size *

Painting A___framed size *

Painting A__sale price (if not for sale, put "NFS") *

Painting B___Title (optional, second painting may be accepted if space allows)

Painting B___unframed size (optional)

Painting B___framed size (optional)

Painting B___sale price (if not for sale, put "NFS")

Comments: (any special information you would like us to know)

Name

SUBMIT ENTRY ___ (assumes you have read the Prospectus and understand your responsibilities for this show.)