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PhotoPlace Gallery Juried Exhibition
Name:________________________________________________
Address:______________________________________________
City:______________________ State:__________ Zip:_________
Telephone:_____________________________________________
E-Mail_________________________________________________
Name of PhotoPlace Gallery Exhibition: ______________________
Submitted Work:
1. Title:
2. Title:
3.
Title:
4. Title: 5. Title:
If additional work is submitted, please list below (note additional submission fee). There is no limit
to the number of submissions.
6. Title:
7. Title:
Total:
$_____________ How did you hear about us? ________________ OR Mail files on CD
with application form to:
PhotoPlace
Gallery 3 Park Street
Middlebury, VT 05753
Please
send SASE if you wish your materials returned.
Submission fee per exhibition: ($25 for first
five images, additional images $6 each). Checks payable to PhotoPlace Gallery, or pay by Credit Card or
PayPal with the link below:
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