Registration Form for CLICK! A Weekend for Wyoming Pinedale , WY
Cut and paste into an MS Word document, complete, and then mail or fax (see contact information below)
Name:
Name:
Address:
City, State, Zip:
E-mail:
Day/Cell Phone:
Registration fee (please circle one):
Early Bird Registration by March 15, 2012, $75
Late and Door Registration, $100
Student Registration, $50
Student Registration, $50
No refunds after March 23, 2012
Registration includes the opening reception, lunch and the Fellowship Awards Banquet.
Payment options (please circle one)
Cash
Check
Visa
MasterCard
Make checks payable to Wyoming Arts Council
May be listed on credit card statements as Wyoming State Museum
Name on Credit Card:
Card number:
Expiration date:
Signature:
Wheelchair
Assisted listening
Large print
Sign language
Other (specify):
Portfolio Review by Wyoming Arts Council Jurors is open to Visual Arts Fellowship applicants. The form to apply is available from: http://wyoarts.state.wy.us./Artists/Visual.aspx or by calling WAC at 307-777-7742.
A room block is available at the Hampton Inn & Suites (307) 367-6700. Reference Click! When calling to receive the conference rate of $79/night.
Mail completed form and payment to: Wyoming 2320 Capitol Ave Cheyenne WY
CLICK! Is sponsored by the Wyoming Arts Council, Pipeline Art Project, University of Wyoming Art Museum, Pinedale Fine Arts Council, Wyoming Cultural Trust Fund, Works of Wyoming and Sublette County Library.
