<p> 3</p><p>REGISTRATIONS OF STUDENT ARTWORK FORM</p><p>VISION 2015</p><p>Complete the following: Include each work entered by your school and submit this Registration Form with all artwork. It is important to type or print legibly.</p><p>Coos Art Museum has received from:</p><p>School Name:______</p><p>Teacher / Contact Name: Daytime Phone______</p><p>Address City State Zip </p><p>Teacher’s email:______Evening Ph. </p><p>The following works of art:</p><p>Title Medium Student Name Grade Year Work Completed</p><p>1. </p><p>2. </p><p>3. </p><p>4. </p><p>5. </p><p>6. </p><p>7. </p><p>8. </p><p>9. </p><p>10. </p><p>These artworks are to be held at the Coos Art Museum from March 12, 2015 until April 18, 2015. </p><p>Delivery Dates: Wed. Feb. 25, Thurs., Feb. 26, & Fri., Feb. 27, 3:00pm-5:00pm. Thurs., March 5, Fri., March 6, 2015 3-5 pm. and Saturday March 7, 2015. Deliver to Coos Art Museum, 235 Anderson, Coos Bay, OR. 97420, telephone 541-267-3901.</p><p>Pickup Dates: Coos Art Museum, Saturday, April 18, 2015, 3pm to 5pm, Sunday, April 19- 10am to noon or Tues-Thursday April 21 - 23, 2015, 10pm to 4pm. If unable to meet the scheduled dates, please contact Coos Art Museum to make special arrangements.</p><p>235 Anderson Avenue Coos Bay, Oregon 97420 phone: 541-267-3901, fax: 541-267-4877, email: [email protected], web: www.coosart.org</p>