GPAN INSTA'llation submission form

Insta'llation Exhibition Submission Form
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Contact Number

Area CodePhone Number
E-mail*
Instagram URL (Let us know if you're on Insta so we can tag your work)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Art*

PaintingSculptureDrawingMixed MediaPrintmakingPhotographyOther
Art Specifications:
Image Description
Title*
Year created*

MonthDayYear
Date
Dimensions (L W H)*
Consent*

I consent for GPAN to use images of my artwork (or parts of it) for the project's social media exhibition.
Attach a well lit, clear photograph of your work here:*

Upload a File
Accepted file formats: GIF, JPG and PNG Cancelof
Should be Empty:

Image Description