Online Store – Art Application First Name: Last Name: Email Address: Primary Telephone Home City: Image File: (2Mb) Title of work: Medium of work Support of work: ---CanvasArchival PaperPhotographic PaperCard BoardFoam BoardWoodAluminumStoneGlassPlasticOther Genre of work: (list any that apply) Size of work in inches: Date work was produced: Description of work: Minimum price the work can be sold for: Maximum price the work can be sold for: Preferred price the work should be sold for: Is the work of art represented by an agent or gallery? ---YesNoIn Transition If work is represented, please provide name of agent or gallery: If work is represented, please provide the current commission %: By submitting this Art Application, you agree to allow Brockton Collective Inc. to promote and showcase your work for the purposes of selling it online at a commission rate of 10%. This application does not guarantee automatic placement of your work on the online store as the work will first be curated by our curatorial committee. Once it is accepted you will be notified of its acceptance and details of placement. Please leave this field empty.