Form B is for Adult Artists (Preschool Through High School Level Artists Use Form A) Click here for Form B in PDF format.
Deadline for entry is April 15, 2003.
Complete this form and then print two copies to be sent with your entry. A completed entry form and one copy of the form must accompany the artwork. All applicable information MUST be completed, or the entry may be disqualified.
Mail your application package to:
APH InSights
American Printing House for the Blind, Inc.
1839 Frankfort Ave.
Louisville, Kentucky 40206-3152
Name of Adult Artist:
Home Address:
City:
State:
Zip or Postal Code:
Daytime Phone with Area Code:
E-mail:
Visual Acuity: Must meet the legal definition of blindness (see "Eligibility" section of the rules). Do not list eye diseases. List a doctor's measurement of your vision. List your corrected visual acuity with glasses or other lens:
Right Eye:
Left Eye:
Or list restricted visual field (percent):
Call 1-800-223-1839, ext. 357 with questions on how to list visual acuity.
Your age at the onset of your blindness?
Your age now?
This entry is sent from:
Agency/School Home
Where should we return art and send correspondence?
Agency/School Home
Which reading medium do you prefer for correspondence?
Print Braille
Indicate your adult category:
Student at an agency or school
Independent artist
Agency/School Name:
Agency/School Address:
City:
State:
Zip or Postal Code:
Teacher's Name:
Agency/School Phone with Area Code:
Fax with Area Code:
E-mail:
What is the last day you will be at your agency/school:
Month:
Day:
Indicate entry category:
Craft
Sculpture
2-D Art
Other
Title of Artwork:
Art Medium/Media:
Value in U.S. dollars (Must be included or work will not be insured.):
Do you want to sell your art?
Yes No
(If yes, your work will be offered for sale at the value listed, plus a 10% handling fee that APH will retain.)
If sending slides, give measurement in inches:
Length:
Width:
Depth (if applicable):
Release: Entry to APH InSights implies permission for APH to reproduce artwork, to retain artwork for up to one year for display purposes, and to publicize the artist by releasing any information provided on the entry form.
©2003, American Printing House for the Blind, Inc.