GNSI 2006 CONFERENCE: JULY 30 -AUGUST 5, 2006 Exhibit Entry Form (Must be postmarked by March 1 or received by March 10, 2006.) Name: Address: City: State/Prov. Zip/Postal Code Country Phone: E-mail: _________________________________________________________ 1 Title: Medium & Substrate: Date: Description: Has entry been published?: Yes No Publication name?: Date: Value (for insurance): $ If not for publication, for what purpose? (i.e. Portfolio? School? Personal exploration of new media?) Category: B/W line____ B/W tone____ Color____ 3-D____ Framed size (2-D work): wide_____ x high______ Size of sculpture (3-D): width_____ x length_____ x height_____ _________________________________________________________ 2 Title: Medium & Substrate: Date: Description: Has entry been published?: Yes No Publication name?: Date: Value (for insurance): $ If not for publication, for what purpose? (i.e. Portfolio? School? Personal exploration of new media?) Category: B/W line____ B/W tone____ Color____ 3-D____ Framed size (2-D work): wide_____ x high______ Size of sculpture (3-D): width_____ x length_____ x height_____ ÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐ Send entries to: Mary Reynolds GNSI Annual Exhibition 2006 2168 N 58th Street Milwaukee, WI 53208 For more information contact: Mary Reynolds 414-771-1377 mjreynolds@wi.rr.com