Print, complete, photocopy and affix sections one and two of entry form to each piece being submitted. Return the entire signed and completed original form with your submissions and check or money order made payable to AMERICAN ILLUSTRATION. Submission acknowledges the right of AMERICAN ILLUSTRATION to use all illustrations submitted for exhibition, publication, or promotion of AMERICAN ILLUSTRATION.
Name ____________________________________________________________________________ Occupation ________________________________________________________________ Company ______________________________________________________________________ Address ______________________________________________________________________ City / State / Zip ________________________________________________________ Phone __________________________________________________________________________ Fax ______________________________________________________________________________
Artist_________________________________________________________________________ Publication / Execution Date _________________________________ Description of Piece_______________________________________________ Category (circle one) 1 2 3 4 5 6 7 8 9 Return Entry: Yes No SASE Pick-Up
No. of Entries Sub Total
________________________$25.00________________________
________________________$75.00________________________
________________________$60.00________________________
Return Charge $ 5.00________________________
Total Amount Enclosed (one check)________________________
______________________________________________________________________________
Signature of Entrant Date
(or Authorized Representative)