PROJEKT30 --  APPLICATION FOR JURIED EXHIBITION 

I. Contact Information 

First Name  _________________________
Last Name ________________________   

Phone (______) _____________________ 

Address ___________________________________________
__________________________________________________
__________________________________________________

Email ____________________________  
 
II. Submitted Media  

Five images are included with the standard application fee.  
Please include an additional $5 for each additional image.  

Image 1                               
Title ________________________________              
Date ______________________
Media _____________________________    
Dimensions  W____  H____  D____         

Image 2 
Title ________________________________ 
Date ______________________
Media _____________________________ 
Dimensions  W____  H____  D____

Image 3                                
Title ________________________________ 
Date ______________________
Media _____________________________ 
Dimensions  W____  H____  D____  

Image 4 
Title ________________________________ 
Date ______________________ 
Media _____________________________ 
Dimensions  W____  H____  D____ 

Image 5                                
Title ________________________________ 
Date ______________________                
Media _____________________________ 
Dimensions  W____  H____  D____       

Image 6 
Title ________________________________ 
Date ______________________ 
Media _____________________________
Dimensions  W____  H____  D____ 

Image 7                                 
Title ________________________________ 
Date ______________________            
Media _____________________________ 
Dimensions  W____  H____  D____ 

Image 8 
Title ________________________________ 
Date ______________________ 
Media _____________________________ 
Dimensions  W____  H____  D____  

Image 9                                
Title ________________________________ 
Date ______________________            
Media _____________________________     
Dimensions  W____  H____  D____        

Image 10
Title ________________________________ 
Date ______________________ 
Media _____________________________
Dimensions  W____  H____  D____  

Do you wish to have your submission materials returned? 
(Requires a SASE) 
 
       Yes          No 
 
 
III. Release for Reproduction 
 
 
I, _______________________________________________ 
hereby authorize PROJEKT30 to display artwork which I have
provided to it by way of slide, reproduction or in digital 
format.  It is my understanding that PROJEKT30 will make 
determinations whether or not to display any or all of my
work that I have submitted.  It is also my understanding 
that PROJEKT30 will display work selected on the Internet 
for review by potential purchasers or individuals or 
organizations that might be interested in further displaying 
my work.
 
It is also my understanding that PROJEKT30 will allow 
potential purchasers or persons or organizations interested 
in further displaying my work to contact me directly via 
email without explicitly disclosing my address.
 
I have paid a fee of $35 to PROJEKT30 for considering 
and/or displaying up to five works of art.  There is a $5 
charge for each additional work of art that I have submitted.  
I understand that PROJEKT 30 will make determinations as to 
what works of art, if any, it will display.  

I am releasing PROJEKT30 and its agents, principals, 
employees or servants from any liability regarding the 
display of work that I have submitted to them, including 
any liability for redisplay by individuals making 
copies of the display made by PROJEKT30. 
 

Signed, ________________________________________________


Date __________________________