2010 Artist Donor Contract

If you have any questions regarding this contract please contact
Art Acquisition Coordinator Lauren Barry
email: LBarry@som.umsmed.edu

Please supply the information requested below. "*" indicates a required field.
*Donor Name:
Artist Name (if different):
*Daytime Phone:
(XXX-XXX-XXXX)		 *Evening Phone:
(XXX-XXX-XXXX)
*E-mail Address:
*Street Address:
*City: *State: *Zip:
Gallery Representation:
*Medium/Description/Title:
*Size (Framed): *Estimated Retail Value:
$		 *Minimum Bid:
$

Note: A minimum bid is strongly encouraged. If none, please state so. Live Auction opening bid will be determined by the auctioneer. Please, no reserve bids.

Commission: PLEASE INDICATE COMMISSION FOR BOTH LIVE AND SILENT AUCTION.
If left blank, 0% commission will be assumed.
*Silent Auction (0-25%): *Live Auction (0-40%):
Placement in the Live Auction will be determined by the Art Committee and a professional auctioneer. To be considered for the Live Auction, both the artwork and the contract MUST be received by January 23, 2010.

ALL ARTWORK MUST BE IN THE POSSESSION OF THE HeARTS ART ACQUISITION COORDINATOR BY WEDNESDAY, FEBRUARY 10, 2010, UNLESS PRIOR ARRANGEMENTS HAVE BEEN MADE WITH THE ART ACQUISITION COORDINATOR.

We welcome all donations but, due to limited display space, may be unable to accept some donations or be required to limit the number of pieces per artist. All donations will be reviewed by the art committee before inclusion in the event.

All donors will receive complimentary admission for two (2) to the event. Your name will be listed at the door. Due to limitations, we will be unable to mail or deliver your tickets. Please complete a separate contract for each individual work of art. A copy of each contract will be made available to you upon request. HeARTS is a 501© (3) tax exempt organization. Your donation is tax deductible to the extent allowed by law. Unsold donations will be returned to the donor. You will only be contacted after the event if your donation DID NOT sell.

If you or your company/gallery have a website and would like HeARTS to put a link from our website to yours, please provide that web address below:

Web Address:
*By checking this box and submitting this form, I agree to all of the above stated conditions and certify that I am the person(s) listed under "Donor Name." I further understand and agree that submitting this form constitutes an Electronic Signature, and therefore a binding contract between myself and Mississippi HeARTS Against AIDS. * (PLEASE CHECK HERE)

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