Boskone 40 Art Show Entry Form

c/o NESFA, Box 809, Framingham, MA 01701-0203

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.
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 § ___ 1/2 @ $21 § (1) ___" x ___" ___ (1-10)
___ 1/2 @ $21 ___ 1/4 @$11 (2) ___" x ___" ___ (1-10)
____ 1/4 @ $11 (3) ___" x ___" ___ (1-10)
(4) ___" x ___" ___ (1-10)
* if available (5) ___" x ___" ___ (1-10)
§ Returning artists only, please. (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 ($10 if permitted) Wait list you for additional space? [ ] Yes [ ] No
$_____ Membership(s) (___@ $40) Refund memberships if no space available? [ ] Yes [ ] No
             Include name & address for addt'l. members (on separate sheet). Rate good through January 20, 2003.
$_____ Total Amount [ ] Check / money order enclosed (payable to "Boskone 40")
[ ] Charge my: [ ] MasterCard or [ ] VISA. Expiration date:___/___

Name on card: ______________________ Card #: ____________________________

Signature: _______________________________________