The Rema Hort Mann Foundation

A Fundraiser Featuring Artwork by LGBTQ Artists
Wednesday, June 24, 6 pm
Benefit Auction Donation Form
Deadline to submit form: Monday, May 18 at noon

Contact Info

Name

Street

Apt

City

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Zip

Phone

Fax

Email

Artwork Info

Title

Date of Work

Medium

Edition number (if applicable)

Dimensions

Short Description

Courtesy of (ie: the artist, donor name and/or gallery)

Proposed auction price

Uploads

Resume

JPG of artwork