Entry form ("The Four Seasons")
Complete and mail this form to 6635 St. Charles Place, Burnaby, BC, V5H 3W1
Name of Artist:
Address:
Phone number:
Email Address:
Description of artwork:
Number of pieces of artwork:
Title (1)SizeMedium
Title (2)SizeMedium
Title (3)SizeMedium
Title (4)SizeMedium
Title (5)SizeMedium
Title (6)SizeMedium
Amount Due:
Method of payment:
Visa, MasterCard or American Express Exp or Cheque payable to Eileen Fong Gallery Please send cheque to: Eileen Fong 6635 St. Charles Place, Burnaby, BC, V5H 3W1
For further enquiries please call Eileen Fong at 604-432-1341 or Allyson MacBean at 604-266-1047 or e-mail: eileen.fong@yahoo.com