Name: _________________________________________________________

Address: _______________________________________________________

Telephone: __________________________________________

e-mail: _________________________________________________________

website:________________________________________________________

Brief Description of Proposed Work:

________________________________________________________________

________________________________________________________________

Please Attach Artist Statement

Please attach proposed image(s). Digitally submitted images should be sent
in jpeg format at a manageable resolution (300dpi is recommended).

Optional: Curriculum Vitae

Optional: Brief biography and photo of artist

Please email this completed submission form to
Member Wall Chairperson
info@galleryvertigo.com

or deliver to

Gallery Vertigo
Suite #1, 3001 - 31ST Street, Vernon, BC
Phone: (250) 503-2297
Hours: Tuesday to Saturday 11:00 AM TO 4:00 PM