Exhibition Registration Form

               2008 IPAT EXHIBIT PRE-REGISTRATION FORM
             3 PIECES WILL BE ACCEPTED FOR EXHIBITION

    MAIL THIS COMPLETED FORM TO:    EXHIBITION CHAIRMAN
    LETHA SANDIFER - 2324 Palm Hills Blvd. - Baton Rouge, LA 70809

Regular * Student * Experimental Youth * Youth Member * Portrait Society Member

You must present your current IPAT Membership Card when you enter your art into the IPAT EXHIBIT.
If a piece is delivered by a friend, they must have your IPAT Membership number.

PLEASE PRINT OR TYPE:

NAME_________________________________________________MEMBER #_____________

ADDRESS______________________________________________________________________

CITY___________________________STATE/PROV___________________________________

COUNTRY_________________________     ZIP/POSTAL___________________

    CIRCLE APPROPRIATE BOXES BELOW:
    Have these pieces been photographed at a previous show/convention?                                 YES       NO

    Have these pieces been submitted to another magazine for possible publication?                 YES       NO

   IPAT, INC has my permission to photograph my art. The Porcelain     Artist magazine has my permission to publish my work with or without
ribbons.               YES      NO


TITLE OF PIECE__________________________________________

SIZE/DESCRIPTION________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

SIGNATURE_____________________________________________            DATE________________