Art Comp Entry Form 3 .pdf

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Original filename: Art Comp Entry Form 3.pdf
Title: headspace Elsternwick Art Competition - Entry Form
Author: Nikita Singh

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headspace Elsternwick Art Competition - Entry Form
Please print this form and bring it in with your piece

Name:
Address:
Contact number:
Email Address:
Age Category: (Please tick)

☐12 -15 years

☐16 – 18 years

☐19 -25 years

Would you like your artwork to remain in headspace Elsternwick should you win your
category?
☐Yes
☐No

Artwork title: (optional)
Artist’s statement: (optional)

Please sign below to acknowledge you have read the Terms and Conditions of entry.
For a copy of the Terms and Conditions refer to the headspace website
(http://www.headspace.org.au/southernmelbourne) or the headspace Elsternwick
Facebook page (https://www.facebook.com/headspaceElsternwick).

Signature

Office use only
Entry number:

Date


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