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New Masters Art Gallery Application for Co-operative Membership Date _____________________ Name _____________________________________ Home Phone ____________________________ Email _____________________________________ Work Phone ____________________________ Web Site __________________________________ Cell Phone _____________________________ Address ___________________________________ City/Zip _______________________________ Medium ___________________________________ Price Range ____________________________ ART BACKGROUND ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________

PREVIOUS GALLERIES, SHOWS, OR EXHIBITS ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________

HONORS, AWARDS, RECOGNITION _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

PLEASE INCLUDE RESUME/BIO & PRINTED EXAMPLES WITH THIS APPLICATION FORM (JURYING REQUIREMENTS): A. Submit application form, resume, and artist statement B. Submit at least 5 samples of your artwork

Your signature on this application will indicate your agreement with the requirements of membership in the NMA Gallery. Signature:______________________________________________ Date:_______________



Application for membership