Arts Auction Donor Form

Submitting online, is EASY!

Please fill out a donor form for each piece of art you submit to the jury. This form is important as it provides the jurors with the necessary information about you and your work. Remember to attach a digital photograph along with your form, and click submit! If you have any questions, please contact:

Arts Auction Coordinator
Mountain Lake PBS
One Sesame Street
Plattsburgh, NY 12901
ph: 518-563-9770 ext. 127
fax: 518-561-1928
email:

NOTE: Fields marked with * are required.

ARTIST'S INFORMATION

Artist's Name*:

Address*:

City/Town/County*:

Province/State*:

Zip/Postal Code*:

Email*:

Primary Phone*:

Fax:

Website:

ARTWORK INFORMATION

Artwork Title*:

Medium*:

Framed Size*:

Original or type of reproduction*:

Artwork Size*:

Value in US Funds ($)*:

Help us to describe your artwork correctly on live TV. What do you want us to say about your work? Please give us the basics of your style and technique. Also tell us about your association with the subject or location and any other information that may be of interest to a potential buyer.

Detailed Description*:

Please list your awards and gallery affiliations and information about your career you’d like us to know. You may want to provide an additional page of biographical information which may be made available at the Preview Exhibitions.

Awards & Gallery Affiliations:

Artist's or Donor's Digital Signature*:

May we add your studio to our Preview Exhibition Catalog?*:

	Yes
	No

May we give your name and address to a bidder/viewer?*:

	Yes
	No

ARTWORK ATTACHMENT

Artwork Upload*:

Fields marked with * are required.