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This form will print onto two sheets of A4 paper. Please staple them together.
Mail to: The Print Center, 1614 Latimer Street, Philadelphia, PA 19103-6398 USA
| For TPC use only Entry#...................................................... selected 2nd................... exhibit............... slides proc...................... return................ |
| . Name:................................................................................................................. Address:.............................................................................................................. City..........................................State...........................................Zip................... Country:.....................................................Tel No........................................... |
My main artistic medium is:
| Printmaking | Photography | Books |
I am a
| New artist member | $30 |
| For two years | $50 |
| New student member | $20 |
| Renewing artist | $30 |
| Current member | paid
after 9/30/95 |
| Entry A Title:.................................................................................... Medium:.............................................................................. Image Size....H..................................W.............................. Insurance value/retail price |
| Entry B Title:.................................................................................... Medium:.............................................................................. Image Size....H..................................W.............................. Insurance value/retail price |
| Entry C Title:.................................................................................... Medium:.............................................................................. Image Size....H..................................W.............................. Insurance value/retail price |
| Entry D Title:.................................................................................... Medium:.............................................................................. Image Size....H..................................W.............................. Insurance value/retail price |
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