Artist Name: __________________________________________________ 3 Initials: ______
Email: ______________________________________________________________________ Home Phone: ___________________________ Cell Phone ____________________________ Entry No.
TITLE / Medium / Description
Price
Date Sold Receipt No.
Date Removed
Work Delivered Artist Signature: __________________________ Date: ____________
SASI Signature: __________________________ Date: ___________ Work Picked up Artist Signature __________________________ Date: ____________ SASI Signature __________________________ Date: ____________