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University Health Lakewood Healing Arts Gallery Interest Form

Please direct questions to Sharon Wagner at SWagner@summitart.org.

First Name

Last Name

Email

Mobile Phone

Website (in applicable)

Display Medium (Must be 2D and appropriate for hanging in a public setting. Maximum hight: 36in. Maximum Width 36in.)

Upload image of artwork to display. This will be used for online sales page. Please show image in frame if applicable.

Artwork Title. Must match your label.

Artwork Medium

Artwork Dimensions (including frame if applicable).

Sale Price. Summit Art retains 30% of the sale price.

Artist Bio and/or Artist Statement