Online Application Form for Aspire Gallery's 2021 'Petite Pieces' Competition. If you have any difficulties filling out this form or would like to submit an offline copy, please email info@aspiregallery.com.au. Please enable JavaScript in your browser to complete this form.Artist Name *FirstLastEmail *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhone *Are you currently represented? If so, by who? Artwork DetailsPlease note that this entry form allows the submission of up to four (4) works. Should you wish to submit additional works, please submit a second entry form. Title of Artwork #1 *Price of Artwork #1 *Medium of Artwork #1 *Size of Artwork #1 (in cm) *Description of Artwork #1 (if applicable)File Upload - Artwork #1 * Click or drag a file to this area to upload. For ease of processing for our team, please ensure your image is titled 'ARTIST NAME-TITLE OF PIECE'Title of Artwork #2 (if applicable)Price of Artwork #2 (if applicable)Medium of Artwork #2 (if applicable)Size of Artwork #2 (if applicable)Description of Artwork #2 (if applicable)File Upload - Artwork #2 Click or drag a file to this area to upload. For ease of processing for our team, please ensure your image is titled 'ARTIST NAME-TITLE OF PIECE'Title of Artwork #3 (if applicable)Price of Artwork #3 (if applicable)Medium of Artwork #3 (if applicable)Size of Artwork #3 (if applicable)File Upload - Artwork #3 Click or drag a file to this area to upload. For ease of processing for our team, please ensure your image is titled 'ARTIST NAME-TITLE OF PIECE'Title of Artwork #4 (if applicable)Price of Artwork #4 (if applicable) Medium of Artwork #4 (if applicable) Size of Artwork #4 (if applicable) File Upload - Artwork #4 Click or drag a file to this area to upload. For ease of processing for our team, please ensure your image is titled 'ARTIST NAME-TITLE OF PIECE'Entry Fee PaymentEntry payment is per piece and entries will not be considered until the non-refundable entry fee has been received. Please remember that entry fee is per piece. Method Entry Fee Payment *Bank DepositEftpos over the phonePaypalFurther details on next page. ConfirmationI accept the Conditions of Entry available at: petite-pieces-conditions-of-entry *YesSubmit
