Moved to Act – Exhibiting Artist Application Form

Please fill in the appropriate information. —> NOTE: “*” indicates required fields.

*Please give us permission to receive and store your information

Contact information

*First Name:
*Last Name:
*Street Address 1:
Street Address 2:
*City:
*State:
*ZIP/Postal Code:
*Country:
*Telephone (include country code if outside US):

*Your Email:
Instagram:
Facebook:
*Website:

Protest/Action Information

*Name of Protest/Action:
Location:
*City: *State:
*Year:

Image Information

Image file specifications: 72 ppi, sized to 1200 pixels longest side and saved to the highest quality possible.

IMPORTANT: Title each jpg as follows: 
Your last name_firstnameinitial_title or part of title depending on length

For example: Feldman_E_TheRedAuto.jpg 

Attach file(s)

(Image file types: jpg, jpeg, png, gif only. MAXIMUM file size = 10 megabytes)
*Image 1:
Image 2:
Image 3

Image Information - minimum 1 - maximum 3

Provide the following information for each image:
Image 1
*Image 1 Title:
*Photo Process:
*Print size (height & width in inches)

Framed print size:

*Edition size (or indicate "none" meaning => "open")

*Price($)("None" means print is not for sale)
(Reminder: sales split between artist and gallery is 50/50% for print; 100/0% for frame)

Other sizes available for Image 1? Include price, photo process and edition information for each size.
*Other size 1: (or "none")
Other size 2:
Other size 3:

Image 2(optional)
Image 2 Title:
Photo Process:
Print size (height & width in inches)

Framed print size:

Edition size (or indicate "none" meaning => "open")

Price($)("None" means print is not for sale)

Optional - Price for framed print

Other sizes available for Image 2? Include price, photo process and edition information for each size.
Other size 1: (or "none")
Other size 2:
Other size 3:

Image 3 (optional)
Image 3 Title:
Photo Process:
Print size (height & width in inches)

Framed print size:

Edition size (or indicate "none")

Price($)("None" means print is not for sale)

Other sizes available for Image 3? Include price, photo process and edition information for each size.
Other size 1: (or "none")
Other size 2:
Other size 3:

*Artist Statement for this and other work in this series
(written in first person and not more than 150 words)

*Artist Bio
(written in 3rd person and not more than 150 words)

Additional information (optional)

Return Shipping Information

Pick One of Four Options

1. Artist encloses return label, stamps or a check for return of your work. The gallery requests you use UPS or USPS for shipping.
2. The gallery will ship your work to you via UPS with signature required. You will be billed for the price of shipping only
3. Arrange with Ellen Feldman to pick up your work in Cambridge.
4. Arrange with Davis Orton Gallery to pick up your work in Hudson NY.

*Make Your Return Shipping Selection Below:

Submit


(Confirmation message for successful submission appears here after you click on “Submit”)