Member Gallery Application Name * First Name Last Name Phone * (###) ### #### Email * Business Name Website and/or Social Media http:// Member Number * Art Piece #1: Name * Art Piece #1: Year Created * Art Piece #1: Medium * (Oil on Canvas, Mixed Media, etc.) Art Piece #1: Size * Art Piece #1: Price * Art Piece #2: Name Art Piece #2: Year Created Art Piece #2: Medium (Oil on Canvas, Mixed Media, etc.) Art Piece #2: Size Art Piece #2: Price Art Piece #3: Name Art Piece #3: Year Created Art Piece #3: Medium (Oil on Canvas, Mixed Media, etc.) Art Piece #3: Size Art Piece #3: Price Thank you!
