West Goshen Township
Resident Exhibit Entry Form

Please print this page, complete the information below, and submit one form with each piece of artwork to the West Goshen Township Administration Building, 1025 Paoli Pike, West Chester, PA 19380 (N. Five Points Road and Paoli Pike) by Thursday, September 1, 2011.

Name:____________________________________

Address:__________________________________

__________________________________________

Telephone Number:_________________________

Title of Entry:______________________________

Type of Artwork:___________________________

I have read and agree to the "Rules for Submission" for the West Goshen Township Resident Art Exhibit.

Signature:_________________________________