1. Your first name *

2. Your last name *

3. First time exhibitor * Yes No

4. Department *

5. Campus address *

6. Phone
Preferred number *

Phone type *
Office Cell Home

7. Email *

8. Do you have a personal web page highlighting your work that you'd like to have listed in the electronic brochure?

URL:
.

Section II – Art Information

Piece #1 Title

1. Medium

2. Size

3. Indicate any special exhibition requirements:

Piece #2 Title

1. Medium

2. Size

3. Indicate any special exhibition requirements:

Piece #3 Title

1. Medium

2. Size

3. Indicate any special exhibition requirements:

Piece #4 Title

1. Medium

2. Size

3. Indicate any special exhibition requirements:

Section III – Music
Do you have a musical talent that you are willing to share with the Mount Holyoke Community? Yes  No

What would you like to perform:

Section IV – Meet the Artist Reception in Kendade Atrium
Thurssday, December 3, 3:30 - 5:00 pm

I plan on attending
All of the reception.
Part of the reception.

I have read the terms below and agree: *

• By entering my work into this exhibit, I expressly understand and agree that I assume all risk of loss of or damage to my artwork or property or any property of others which I may have, leave or store in Kendade or anywhere on Mount Holyoke property and that Mount Holyoke is not and will not be responsible for any loss to any of my property, property in my care, custody or control, or property of others that I may have, leave or store anywhere on Mount Holyoke property. 
• In consideration of having my work shown in this exhibit, and by entering this exhibit, I agree to release Mount Holyoke College, its trustees and employees of any and all liability for any loss or damage to my property, whether caused by their negligence or any other causes.