For official use only

Release of unsold exhibits Date: ………………………………………..……

We regret that the numbered exhibit(s) below have not attracted a buyer and you are authorised to recover same:

……………………………………………………………………………………………………………………………………………………………………………………….

Received in good order: Signed: ………………………………………….

Exhibition Entry Form

Rotary
Art Exhibition and Sale
17 June – 23 June 2019
GARDEN CITY SHOPPING CENTRE
Closing date for entry forms: Monday 10 June 2019

Name: Address: Postcode:

Email: Telephone:

Title Price No. Sale

* Prices may be adjusted at the time of delivery.

* This form must reach: Rotary Art, PO Box 3023 SHELLEY WA 6148
OR if hand delivered to 8 Pleasant Place, SHELLEY WA 6148. No later than Monday 10 June 2019. If payment is by
credit card, the form can be emailed to melville.rotary@jtmorris.com.au

I accept the conditions for the Rotary Art Exhibition Sale and certify that the entry is my own work.

I enclose $ ……………………… being for …………. Paintings @ $15 each

Signature: …………………………………………………………………………… Date: ………………………………….

Payment
Cheques to be made payable to: "ROTARY ART EXHIBITION”
Credit Card
Payment Name on card: ……………………………………………………………….…………………………………………………………………..…..

Card Number: ……………………………….…………………………….…………………………………………………………………………

Expiry Date: ………………………………. CVV: …..…………………

* Credit card information is not retained by Rotary and is only used for the purpose provided of payment for Exhibition Entry. Once payment is successfully completed
this section is removed and destroyed.