CROSSROADS ART CENTER

RESERVATIONS

FOR SPACE

A _____________ deposit is required to reserve your space number __________. This deposit will be deducted from the initial total rent payment, should you be approved, or will be refunded in the event that you do not rent the space.

You are required to bring in for jurying a minimum of 5 pieces of your original framed artwork and a resume. Plus, you will be charged a $25 fee for the juror process.

First Name: ____________________________ Last Name:______________________________

Address: ______________________________________________________________________________

City: _________________________________ State: ____________ Zip: _______________

Office Number: _______________________ Home Number: ____________________________

Cell Number: _______________________________

Email: ______________________________

Medium:

______________________________________________________________________________

____________________ ______________________

Artists Signature CAC Signature