Art Galore! Agent Application Form

Name___________________________________________________Phone________________
Address_________________________________________________E-mail________________
City_______________________________________State________Zip_____________
Make sure that each photo or slide is marked with an identification number.
Image ID____Title___________________________________Medium_____________________
Artist____________________________________________________________________
Image Size: ______ in by _______ in (by _______ in for sculpture)
If unframed but matted, outside mat dimensions: ____ in by ____ in
If framed, outside frame dimensions: ____ in by ____ in
Price____________ (even dollars, no cents)
If print or reproduction, edition limit_________
Image ID____Title___________________________________Medium_____________________
Artist____________________________________________________________________
Image Size: ______ in by _______ in (by _______ in for sculpture)
If unframed but matted, outside mat dimensions: ____ in by ____ in
If framed, outside frame dimensions: ____ in by ____ in
Price____________ (even dollars, no cents)
If print or reproduction, edition limit_________
Image ID____Title___________________________________Medium_____________________
Artist____________________________________________________________________
Image Size: ______ in by _______ in (by _______ in for sculpture)
If unframed but matted, outside mat dimensions: ____ in by ____ in
If framed, outside frame dimensions: ____ in by ____ in
Price____________ (even dollars, no cents)
If print or reproduction, edition limit_________
Image ID____Title___________________________________Medium_____________________
Artist____________________________________________________________________
Image Size: ______ in by _______ in (by _______ in for sculpture)
If unframed but matted, outside mat dimensions: ____ in by ____ in
If framed, outside frame dimensions: ____ in by ____ in
Price____________ (even dollars, no cents)
If print or reproduction, edition limit_________
Image ID____Title___________________________________Medium_____________________
Artist____________________________________________________________________
Image Size: ______ in by _______ in (by _______ in for sculpture)
If unframed but matted, outside mat dimensions: ____ in by ____ in
If framed, outside frame dimensions: ____ in by ____ in
Price____________ (even dollars, no cents)
If print or reproduction, edition limit_________

The undersigned affirms that he either owns all rights to sell and reproduce all artwork he submits now or at any other time, or has obtained sufficient authority from the owner to permit Art Galore! to sell, reproduce, or have reproduced these images without infringing the rights of any person. The undersigned agrees to permit Art Galore! to reproduce and use these images for the purpose of promoting and selling the artistís work, and to indemnify Art Galore! from any claims of liability from any actual or alleged inaccuracy in this affirmation.

Signature_________________________________________Date_________________
Art Galore!, 5722 Gloucester Drive, Tyler, Texas 75707