Cultural Arts Connection

Artist Registry & Gallery Registration Form

Artists wishing to become part of the Artist Registry & Gallery, please complete all the information requested below and click the submit button. All artists featured on our site must pay a yearly membership fee and mail the printed form that will be generated at the end of registration process.

Yes, I would like to be a part of the Artist's Registry & Gallery on the Web. I understand I am responsible for contacting any referrals forwarded to me from Cultural Arts Connection. My personal information is kept confidential by Cultural Arts Connection and will not be given to any third party without my permission. (After filling out the information below, please send up to four individual image files containing pictures of your original work to elaarts@aol.com. Please write this address down as a reminder. Accepted formats are: JPEG, GIF, BMP, TIFF, PSD.) Along with the image files, please include in the email: Title of artwork, size, media and brief description.
Yes, I would like to be a part of creating an Artist Showcase in the Lake Zurich area. (This program requires volunteer time to help administer the program, and for set up and take down of your exhibit in the Artist Showcase.)
Yes, I would like to be included in your Artists' email list. Please notify me about all cultural opportunities such as auditions and call for artists.
Yes, I would like to receive your newsletter about general cultural events and happenings.
Artist Information:
First Name
Last Name
Street
City
State	Zip
Home Phone Number	() -
Work Phone Number	() -
Email

Select the category that best describes your primary MEDIUM:
Acting
Calligraphy
Collage
Curator
Dance
Digital Photography
Drawing
Education
Fiber
Fine Craft
Glass Art
Illustration
Jewelry
Mixed Media
Metals
Music
Mural
Paper Making
Painting
Performance
Photography
Poetry
Pottery
Printmaking
Sculpture
Writing
Other

Biographical Information (up to 150 words)

Include your mission with your art, how you got started, and any other “human interest” information.

Addition comments:

* All personal information gathered is held strictly confidential and is not sold to any third party.

	This website is partially supported by a grant from the Illinois Arts Council, a state agency.
	P.O. Box 365, Lake Zurich, IL 60047 Telephone 847-540-1919 FAX 847-540-8457 General Information: ElaArts@aol.com Copyright © 2003 Cultural Arts Connection. All rights reserved