Exemplary 2011 Entry Form

Note: You can print this order form in most browsers by selecting Print from the File menu. Print and use one form per entry. Please print or type.

Title as it should appear on the exhibit card:

______________________________________________________

Entry Dimensions:

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Entrant's name, as it should appear on the exhibit card:

______________________________________________________

Address:__________________________________________________

_________________________________________________________

City:_____________ State:_____________ Zip:______________

Telephone (day):____________________________________

Telephone (pm):__________________________________

Email Address:_______________________________________________________

Delivery information:
The entry will be (mark only one):
______ delivered in person.
______ shipped (see below)

Return information:
The entry will be:
______ picked up in person.
______ returned via the US Post Office.
______ returned via delivery service:
     ___ UPS    ___DHL   __FedEx
Return shipping insurance value: $____________________________
Pre-paid return shipping label must be enclosed.

Entry Category (mark only one)
______ Amateur
______ Professional

Judged entries:

______	Original
______	Non-original with Instruction
	Source: __________________________________
______	Non-original w/o Instruction
	Source: __________________________________
______	Mixed Media
______	Japanese Embroidery
______	Challenge

Entry Type (picture, box purse, etc)

__________________________________

Non-judged displays:

Entry Options (mark all applicable items)
______ This entry is not for sale.
______ This entry is for sale. The sale price is: ______________________________________
Seller agrees to the terms of sale. Signed:_________________________________________________________
Date:_________________________________________________________

______ Critique this entry ($25 fee).
______ Do not critique this entry.

______ Permission is granted to The Academy to photograph this entry for educational and archival purposes and/or use on the Academy Web site. 

Signed:_________________________________________________________
Date:_________________________________________________________

Fees: Make checks payable to the "National Academy of Needlearts". Entrant responsible for shipping and insurance.

Send Entry Form(s), Artist Statement(s), and Fees, by Janurary 29, 2011 to:

NAN Exhibit
7912 Elkhorn Mountain Trail
Austin, Texas 78729
E-mail