Youth Art Entry Form "*" indicates required fields 1Exhibitor Information2Art Information3Payment Art Show entry deadline is December 15, 2023.Exhibitor Name* First Last Date of Birth* MM slash DD slash YYYY Email* Phone Number*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School* Teacher Name First Last Teacher Email Teacher Phone Entry*Age Division* Junior Division (4th - 8th Grades) Senior Division (9th - 12th Grades) Art Entry (Junior Division)* Traditional Photography Select AllArt Entry (Senior Division)* Traditional Photography Digital Sculpture/3D Select AllTotal Title of Traditional Art Piece* Medium of Traditional Art Piece* Inspiration of Traditional Art Piece*What inspired you to create this piece? Or, why do you love to create art? This answer may be used for marketing purposes.Title of Photography Art Piece* Medium of Photography Art Piece* Inspiration of Photography Art Piece*What inspired you to create this piece? Or, why do you love to create art? This answer may be used for marketing purposes.Title of Digital Art Piece* Medium of Digital Art Piece* Inspiration of Digital Art Piece*What inspired you to create this piece? Or, why do you love to create art? This answer may be used for marketing purposes.Title of Sculpture/3D Art Piece* Medium of Sculpture/3D Art Piece* Inspiration of Sculpture/3D Art Piece*What inspired you to create this piece? Or, why do you love to create art? This answer may be used for marketing purposes.Photo of ArtistMax. file size: 10 MB.Please provide a photo of the artist. This can be as easy as a selfie or the artist creating his/her piece. This photo may be used for marketing purposes. Payment Type* Credit Card Pay by Mail If a school is paying for a student's entries the student may select "Pay by Mail". All other entries must be paid by credit card upon entry. Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Billing Info ZIP Code Total CommentsThis field is for validation purposes and should be left unchanged.