Wufoo

Registration Form - Boardwalk Artists at Alderney

In partnership with Halifax/Dartmouth Canada Day Celebrations:
July 1st, 10:00am - 6:00pm

Please fill out this form and return it by June 12, 2009

Name First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone ### - ### - ####
Email
Media Categories: Check one the following categoies, if applicable. *
Paintings Watercolours Drawing Printmaking Photography and photo-based arts Computer generated arts Sculpture Decorative/Applied arts Ceramics Jewlery
Fee $20.00 (which includes 13% HST)

Please contact Kim Farmer (kim@alderneylanding.com or 461-4698) to arrange payment.
Please make cheque, or money order, payable to "Alderney Landing"

Note: By submitting this application form, you are confirming that you have read and understood the applicable Terms and Conditions of Participation.
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