Boskone 41 Art Show Entry Form

c/o NESFA, Box 809, Framingham, MA 01701-0203 – FAX: 617-776-3243

I have read and agree to abide by the rules enclosed with this entry form. Date: ___/___/___

Artist or Authorized Signature (required) __________________________________________
Artist name ______________________________ Agent name ______________________________
& address ______________________________ & address ______________________________
(required) ______________________________ (if any) ______________________________
______________________________ ______________________________
Telephone ______________________________ Telephone ______________________________
Electronic mail ______________________________ Electronic mail ______________________________
Check here [ ] if all communication should be via your agent.
Check here [ ] if we should not send confirmations by electronic mail.
My art will arrive at the show: [ ] with me, [ ] with my agent, [ ] other:
Return artwork to: [ ] me, [ ] my agent. [ ] In person, [ ] by other means:
Panel Space Table Space Print Shop
___ Dbl. @ $84 § ___ Full @ 42 § Item Overall Size # Copies
___ Full @ $42 § ___ ½ @ $21 § (1) ___" x ___" ___ (1-10)
___ ½ @ $21 ___ ¼ @ $11 (2) ___" x ___" ___ (1-10)
___ ¼ @ $11 (3) ___" x ___" ___ (1-10)
§ Returning artists only, please. (4) ___" x ___" ___ (1-10)
(5) ___" x ___" ___ (1-10)
The total of panel and table space must be one or less, with no more than ½ table. Requests for additional space may be granted (6) ___" x ___" ___ (1-10)
(7) ___" x ___" ___ (1-10)
(8) ___" x ___" ___ (1-10)
(9) ___" x ___" ___ (1-10)
Send Bid Sheets for ____ items. (10) ___" x ___" ___ (1-10)
(Bid sheets not needed for Print Shop items) Total # of copies (0-100): _____
$_____ Art Show Fee (total panels & tables) Special Requests: ____________________________
$_____ Print Shop Fee ($1 per copy) ___________________________________________
$_____ Mail-in fee ($20 if permitted) Put on wait list rather than reject request? [ ] Yes [ ] No
$_____ Membership(s) (___@ $41) Refund memberships if no space available? [ ] Yes [ ] No
===== Include name & address for addt'l. members (on separate sheet). Rate good through January 18, 2004.
$_____ Total Amount [ ] Check / money order enclosed (payable to "Boskone 41")

[ ] Charge my: [ ] MasterCard or [ ] VISA. Expiration date:___/___

Name on card: ______________________ Card #: ____________________________

Signature: _______________________________________