Picture Placitas Entry Form
Name: __________________________
Address: ________________________Phone__________________Email:_________________
Titles
1_________________________________
2.________________________________
3.________________________________
Entrant's background (in 50 words or less, use other sheet if necessary.)
WAIVER OF LIABILITY: In submitting my work for PICTURE PLACITAS, I warrant that this is my original work and that there is no copyright infringement. If the art work contains easily recognizable people,all necessary releases have been included with this submission. I understand that the art work will not be returned to me, but will become the property of the Placitas Library.
Signature:
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