First Name (required)
Surname (required)
Address 1 (required)
Address 2
Town / City (required)
Post Code (required)
Contact Phone (required)
Email (required)
Young Artist Award — Date of Birth
Only provide this if you want to be considered for the Young Artist Award.
Bank Account (required)
Artwork 1
Category (required)Select a categoryCategory 1 - Painting / 2D MediaCategory 2 - Printmaking / Photography / Digital GraphicsCategory 3 - 3D Media / Sculpture / JewelleryCategory 4 - Textile / Embroidery / Stitch
Title (required)
Medium (required)Select a mediumOil PaintingAcrylic PaintingWatercolour PaintingMixed Media2D dimensional mediaPrintmakingPhotographyDigital graphics3D mediaSculptureJewelleryTextileEmbroideryStitch
Price (required)$
Artwork 2 (optional)
CategorySelect a categoryCategory 1 - Painting / 2D MediaCategory 2 - Printmaking / Photography / Digital GraphicsCategory 3 - 3D Media / Sculpture / JewelleryCategory 4 - Textile / Embroidery / Stitch
Title
MediumSelect a mediumOil PaintingAcrylic PaintingWatercolour PaintingMixed Media2D dimensional mediaPrintmakingPhotographyDigital graphics3D mediaSculptureJewelleryTextileEmbroideryStitch
Price$
Artwork 3 (optional)
Entry fee is $35 per entry (non-refundable), limited to 3 entries.
Bank Account for Payment of Entry Fee: Otago Art Society Inc. 02-0929-0274457-000
Bank Reference — Particulars: Your Name, Reference: Cleveland
Entry Fee Paid Via (required)Direct CreditOAS Gallery Shop
Date Paid (required)
Amount (required)Select amount$35$70$105
Please email a photo of each artwork to otagoartsociety@xtra.co.nz, naming each file with your full name and the artwork title.
Date Photo Submitted (required)
Do you consent to your artwork being sold through layby? (required)YesNo
Do you consent to your artwork being removed from the exhibition early if sold? (required)YesNo
Tick only those that apply to you.
I will pick up unsold artworks myself
I authorise someone else to pick up the unsold artworks on my behalf
I am from out of town and have included my pre-paid return courier ticket
If you authorised someone else, please name them here
I agree to the Terms and Conditions of the Cleveland National Art Awards as outlined on the pages issued prior to this Entry Form. I certify that I am an Exhibiting, Student or Life member of the Otago Art Society and the entry fee has been paid.
Signature — type your full name (required)
Date (required)
