First Name: Last Name:

Address:

City : State: Zip Code:

Daytime Phone:

Evening Phone:

Email Address:

Yes, I would like to participate in Art Roulette *
*Participating artists will be provided with an 8.5" X 5.5" sheet of paper with the opportunity to create a piece of work in addition to the work submitted for the auction. Feel free to use your own paper as long as it fits the provided envelope. These pieces will be placed in unidentified envelopes for purchase during the event. All pieces will be sold for $25.00 on a first-come, first-served basis. All "Art Roulette" participants will be listed seperately, in addition to the contributors list. Please note that in order to participate in "Art Roulette" you must be a contributing artist in the auction.

(Only click submit once. After the form is successfully submitted you wil be returned to the Artworks page.)