Small Works 2021 – Submission Form

Small Works 2021 - Submission Form

Name*
First Last
Phone*
Email*
Title
Medium
Price
Submission fee*
- One entry ($10)
- Two entries ($20)
Open only to current Alliance for the Arts members, $20 for 2 entries.
Additional donation to the Alliance Quantity
Price: $5.00
Love the Alliance? Say it with a $5 (or more) one-time gift! Your optional donation supports the future of arts in southwest Floridaa.
Renew Membership
- Individual ($55)
- Family ($80)
- Traveler ($125)
- Friend ($250)
- Patron ($500)
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Total
$0.00
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