2012 Boneyard Arts Festival Registration Form

2012 Boneyard Arts Festival

Thursday, April 19 - UI Campus • Friday, April 20 - Champaign
Saturday, April 21 - Urbana • Sunday, April 12 - Out & About Champaign County

2012 Boneyard Arts Festival Registration Form
COMPLETE AND SUBMIT THE FOLLOWING FORM BY MARCH 15 TO BE INCLUDED IN THE 2012 BONEYARD MAP.

Venue Information

Venue *

Street Address *

City, State, Zip *

Venue Website

Venue Contact Name *

Venue Contact Email *

Venue Contact Phone Number *

Artist Information
(More than one artist at this venue? See below to list additional artist names.)

Artist/Organization Main Contact *

Street Address *

City, State, Zip *

Email *

Phone Number *

Website

Indicate your Boneyard District *

UI Campus (April 19)

Champaign (April 20)

Urbana (April 21)

Out & About (April 22)

Is art work for sale at this venue? *

Yes

Is there an admission fee? If yes, how much? *

Are there any age restrictions? If yes, please provide details. *

More than one artist at this venue? Please list the names and email addresses of all those confirmed

(if multiple artists are participating in this venue's events or exhibits, please select one individual to act as contact):

Describe the exhibits, displays, performances, or family events taking place at this Boneyard venue including dates and hours *

(please limit to 200 words):

Registration Fee *

Check (made payable to 40 North and mailed or dropped off at 106 S. Neil St., Champaign, IL 61820)

Invoice me

Credit Card (Paypal - you will be redirected to paypal to complete the purchase upon form submission)

Participation in the Boneyard Arts Festival is free to all artists. Venues are charged a flat $50 fee to be listed in the Official Boneyard Arts Festival Map and online at www.40north.org. Payment options are (check one):

Signature *

By checking this box you are electronically providing your signature and agreeing to all information provided above.

Questions? Contact Janet Soesbe, Boneyard Festival Chair, at jlsoesbe@urbanaparks.org or Kelly White, 40 North Interim Director at kwhite@40north.org, or call 217.351.9841.