Member Application

Make your check payable to Winchester Art Guild and mail to

Elizabeth Chalfant, 255 Stonecrest Road, Winchester, KY. 40391

2012 Daniel Boone Pioneer Festival

Name_______________________________________________________

Address______________________________________________________

City________________________State_________________Zip_________

Phone__________________________Email_________________________

Number of 10’ x 10’ spaces:_________(maximum of 2) at $30 each.

Outdoor on the park________ or Indoors in the gym _______Check one

List items to be exhibited:____________________________________________________

____________________________________________________________

Signed______________________________________Date_____________