* 1. Artist Name:

* 2. Title of work:

* 3. Medium of work:

* 4. Paper Size (w x h):

* 5. Price (excluding commission):

* 6. Are you registered for GST?

* 7. Your ABN (if applicable):

* 8. Artist statement (maximum 30 words):

* 9. How would your prints be delivered?

* 10. Image of art work:

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