Registration form for Open Studios 2011

Page 1

Chocolate Factory Open Studios 2011 Saturday & Sunday 12/13 November from 12-6pm, Private View 11 November, 6-9pm

Artist Registration Details Open Studios 2011 1) Please write details clearly as you wish them to appear on publicity materials Name ________________________________________________________________ Art form_______________________________________________________________ Contact information: Studio number and location

______________________________

Phone

________________________________

Email

________________________________

Website

_______________________________

2) I have an up-to-date artist profile on the Chocolate Factory Artists website Yes

No

please circle as appropriate

3) I wish to register for Open Studios 2011 and have enclosed a payment of ÂŁ85 Signed:

______________________________

Date:

______________________________

Please return this form with registration fee to: Collage Arts, 2nd floor, Chocolate Factory 2, 4 Coburg Road, London N22 6UJ by Friday 3rd June 2011

OFFICE USE ONLY Date & amount paid:

Receipt no:

Signed:


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