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NCCALL, Inc. Application for “Autists”

Deadline October 1^st 2008

 

Name: ___________________________________________

 

Address: __________________________________________ _______________________________________________

_______________________________________________

 

Telephone: _____________________________

 

Email: ________________________________

Age: (optional) __________

 

Male: ____     Female: _____

 

Tell us about your artwork:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Title of submitted artwork: _______________________________________________

 

I, the “Autist”, or my legal representative, recognize the terms set forth in this call for entries, and by signing this application, I/we agree to those terms. NCCALL, Inc. shall not be held responsible for unintentional misrepresentation and will take necessary steps to correct any errors. I understand my application information will be for NCCALL, Inc. only, and only my name will be published in conjunction with my artwork unless otherwise requested.  All entries will become property of NCCALL, Inc. to use for promotional and marketing purposes.

 

NEW for 2008: Autists 18 years old and over, or legal representative/parents, may choose which contact information to include with entry in on-line  exhibit.

 

Autist Signature: _____________________________________

 

Legal Representative or Parent: _____________________________

 

Mail submissions to:   NCCALL, Inc.     P/O Box 935      Franklin, NC. 28744