<p> ArtSelect Artist Donation Form February 25, 2011</p><p>Artist/Donor Name: ______</p><p>Donor/Artist’s Address: ______</p><p>City: ______State: _____ ZIP: ______</p><p>Phone: ______E-mail: ______</p><p>Title of Work: ______</p><p>Description of Work: ______</p><p>Retail Value $ ______Size: (HxWxD) ______Medium: ______</p><p>Is this an original piece of artwork? Yes ______No ______</p><p>Biographical Information (please attach a separate sheet, or write on back of this form):</p><p>NOTE: Two-dimensional artwork does not need to be framed necessarily but should be presentable for display. However, unframed artwork may not be able to be displayed at the Cultural Arts Center for the month leading up to the event. The FAC plans to rotate a display of all donated artwork at the CAC gallery.</p><p>Please drop off and form by February 1st to: The Frederick Arts Council 15 W. Patrick Street Frederick, MD 21701</p><p>ARTIST AGREEMENT</p><p>By signing below, I have voluntarily donated a piece of artwork to the Frederick Arts Council for the purpose of the ArtSelect event. I acknowledge that the art will be included in an art lottery event and attendees will have an opportunity to select my artwork from other pieces available. If my piece is not selected, I understand that the artwork will become the property of the Frederick Arts Council and can be placed on permanent display, sold, or used at future fundraisers with all proceeds benefiting the organization. I understand that work submitted will be viewed by the organizing committee, and there is a possibility that pieces may not be used for the auction. I also understand that if my work is accepted, it will be displayed and presented for sale in an auction format which may include pairing the work with others. Also, I will be provided with a complimentary ticket to the event and understand additional guest tickets will need to be purchased. And finally, images of my art and/or my name may be used for publicity purposes.</p><p>Artist’s Signature: ______Date: ______</p><p>Questions? Call 301-662-4190 or email [email protected]</p>