OUR OZARKS IN ARTWORKS ENTRY FORM

Name *

First

Last

Mailing Address: *

City/State/Zip: *

Email Address: *

Contact Phone Number: *

Number of entries: *

Entry fees are $5.00 per submission or $20.00 for 5 entries (that's 4 entries + 1 for free!) --- Entry fees are to be paid when competition pieces are brought to the museum. Cash, debit/credit, or check (please make checks payable to HARLIN MUSEUM). Choose your form of payment by checking one of the boxes below:

Cash
Debit/Credit (add $1.00 processing fee)
Check

Entry Name (Category/Medium) *

Each entry must be titled; entry names may be used to convey how the piece applies to the show's subject or theme.*NOTE: Please include the medium of your piece.

Entry Name (Category/Medium)

Each entry must be titled; entry names may be used to convey how the piece applies to the show's subject or theme.*NOTE: Please include the medium of your piece.

Entry Name (Category/Medium)

Each entry must be titled; entry names may be used to convey how the piece applies to the show's subject or theme.*NOTE: Please include the medium of your piece.

Entry Name (Category/Medium)

Each entry must be titled; entry names may be used to convey how the piece applies to the show's subject or theme.*NOTE: Please include the medium of your piece.

FREE- Entry Name (Category/Medium)

Each entry must be titled; entry names may be used to convey how the piece applies to the show's subject or theme.*NOTE: Please include the medium of your piece.

Please include any questions or comments that you may have in the space below:

Name