Nillumbik Prize - Entry Form

* Indicates Required Field

Artist Details

First Name *     Surname *   
Address *
Suburb *
State *
Postcode *
Phone *
Mobile
Email *
Please upload an Artist CV (One A4 page only – only one page will be considered)
Are you GST Registered? *  
How did you hear about the Nillumbik Prize 2017? *  











Details of Entry 1

Title *
Date Created *
Please note: The work must have been created after June 2015.
Medium *
Height * cm
Width * cm
Depth cm
UPLOAD ARTWORK IMAGES:
Specifications: High resolution JPG, min 500kb, max 1MB
Files must be named in this format: surname_first name_work title_date_medium_size
  • 2D work: One image for each work
  • 3D work: Up to two digital images for each
Artwork Image *
Artwork Image 2
Please provide a statement about the work (no more than 150 words)
Price *

Details of Entry 2

Title
Date Created
Please note: The work must have been created after June 2014.
Medium
Height cm
Width cm
Depth cm
UPLOAD ARTWORK IMAGES:
Specifications: High resolution JPG, min 500kb, max 1MB
Files must be named in this format: surname_first name_work title_date_medium_size
  • 2D work: One image for each work
  • 3D work: Up to two digital images for each
Artwork 2 Image
Artwork 2 Image 2
Please provide a statement about the work (no more than 150 words)
Price

Artist Declaration

Please indicate how you meet the criteria for entry *

Please Provide Working Details / Statement of Connection
I have read and agree to the Conditions of Entry *
I warrant that the work is original and does not infringe the copyright, moral rights or other rights of any third party. *
Please note: The entry fee of $15 applies to each artwork entered in the Prize, including those not selected for exhibition. Your entry will not be eligible for selection until payment is made. Payment for your entry can be made in person at Montsalvat, by cheque or over the phone by credit card.
To make over the phone payments please call (03) 9439 7712.