WILDERNESS
 REQUIRED ONLINE ENTRY FORM


SUBMISSION AND EXHIBITION AGREEMENT


ENTRY FORM (up to 12 entries)

Required fields are marked in red. If any are not applicable then state N/A.
The contact information you provide should be one-hundred percent accurate and used regularly. This is especially important for the email address and phone number, as this is the only means by which we can contact you regarding your submission.

Your name:

First: Last:

Address:

Street:

City: State/Province: Zip/Postal Code:

Country:

Phone:

E-mail:

Enter e-mail again:

NOTE! PLEASE whitelist email from the domain manifestgallery.org or you may not receive our communications about this project. If you do not receive a copy of this entry form by email, please check your spam box. Your email address will be added to our digest list for opportunity emails (you will be able to adjust or remove your subscription at any time.)


Where did you learn about this opportunity? (Please be specific)

Status: (select one)

If Student, please tell us where you study and at what level (e.g. University of Montana, junior):

Your Website:



Facebook handle:

Twitter handle:

Instagram handle:


Number of Entries:


Entry fee total: $40 for up to four, $5 each additional entry.

I will mail entry fee (send to: Manifest Gallery, WILDERNESS, P.O. Box 6218, Cincinnati, Ohio 45206)
I prefer to use paypal or credit card (a link to paypal will be provided upon submission of this form)

I will be submitting my entries by:


attachment (send to show@manifestgallery.org). Please do not send files via Google links.


NOTE!!: Errors in your text may become part of history. Please double-check your information for spelling and accuracy. You will receive a copy of this information by email to the address you provide above. If you find the info. to be incorrect at that time, you may replace the form by submitting a completely new one.

ENTRY 1

Title:

Medium:

Size in Inches (h x w x d) in inches: (Please provide size of work as shown in entry image—not framed size unless frame is included in image. Or duration if applicable.)

Date:

Sale Price (or NFS):
Insurance Value:
Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 2

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 3

Title:
Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:
Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 4

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 5 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 6 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 7 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 8 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 9 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 10 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 11 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

ENTRY 12 ($5 fee)

Title:

Medium:

Size in Inches (h x w x d) in inches: (or duration if applicable)

Date:

Sale Price (or NFS):

Insurance Value:

Viewing Link: (for video entries only)

Notes: including specification for presentation method: framed/matted, mounted, etc., (no more than one paragraph with no line-breaks please):

 

Please note: Some browsers may provide a warning that this form is not secure. This is because our forms are sent via email to you as a receipt, and to our system for our records. The information you are providing here is not something that is sensitive. Do not supply any information here that you would not also be comfortable emailing directly to our staff.

We purposely do not request information here that would be considered a security risk.

Our forms do not collect any sensitive information like payment info, bank accounts, credit card info, etc. We only require either publicly available info or that which would be published as part of your participation in an exhibit. All payment info, if done electronically, is handled through PayPal which is through their own secure connection.

Double check the information you entered above.

Checking this box and clicking SUBMIT indicates that you agree with the conditions of entry and exhibit as outlined in the prospectus, that you are reserving these spots in our jury, that you will send the entry fee, and that you agree to ship or deliver your work on time should it be selected for exhibit. This also means you agree not to double-book or otherwise create conflicting obligations for these specific works until after notification of our jury results, that the information you have provided above is complete and accurate, and that you own the sole copyright to images/artwork/text submitted under your name.

A copy of your entry will be automatically sent to the e-mail address you provided. If for any reason you submit your entry form more than once, only the most recent form will be retained in our system. All previous forms will be deleted.
Please print and retain the e-mail for future reference. If you do not receive this email right away, please check your spam box.