FORMS

NOB HILL GALLERY HOME

7400 Montgomery Blvd Suite 19

ALBUQUERQUE_,NM 87106

(505)268-9969

nobhillartgallery.com

APPLICATION FOR MEMBERSHIP

(Please Type or Print All Information Clearly)

NAME ____________________________________________________________________

PHYSICAL ADDRESS _______________________________________________________

MAILING ADDRESS ________________________________________________________

EMPLOYMENT ____________________________________________________________

HOME PHONE ___________________ WORK PHONE ___________________________

FAX NUMBER ___________________ E-MAIL ADDRESS ________________________

LIST MEDIA IN WHICH YOU WORK AND PRIORITIZE WHAT YOU WISH TO EXHIBIT __________________________________________________________________

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PRICE RANGE OF YOUR WORK AT PRESENT _________________________________

WHO REFERRED YOU TO US? _______________________________________________

CURRENT OR RECENT AFFILIATIONS WITH GALLERIES, MUSEUMS, SHOWS, ARTS ORGANIZATIONS, PUBLICATIONS, ETC.(Please list no more than five and be specific as possible.) __________________________________________________________

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EXPERIENCE WITH OTHER COOPERATIVE BUSINESS VENTURES? (Please

explain) ____________________________________________________________________

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DO YOU HAVE OTHER COMMITMENTS AND OR PHYSICAL LIMITATIONS

THAT WOULD RESTRICT GALLERY PARTICIPATION? If so, please explain. (This would not disqualify you from membership. However, members are required to sit the gallery approximately 10 hours/month, attend monthly meetings on the second Monday at 6:00 PM at the gallery, attend openings, serve on a committee, participate in curating, and help with physical maintenance of the gallery.) _____________________________________________

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PLEASE GIVE A SHORT STATEMENT ABOUT WHY YOU'D LIKE TO BE A

MEMBER _________________________________________________________________

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A COPY OF THIS APPLICATION SHOULD ACCOMPANY YOUR SUBMISSIONS FOR JURYING. You can submit up to 3 pieces of gallery-ready arttt'ork in each medium and include with the application slides, photos, brochures, or other concise promotional material. We would like you to be present at the beginning of our meeting to present your work. Please include a stamped. self-addressed envelope for notification after jurying.

Every precaution will be taken to ensure the safety of your artwork, but the Nob Hill Gallery cannot be responsible for loss or damage to work you leave with us. Please sign below to confirm your understanding of this agreement

SIGNATURE ________________________________________________ DATE ___________________