Nomination - MyPlace on Canvas - an exhibition of paintings by Rod Coyne at the Tinahely Courthouse Arts Centre

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Nomination

Nomination

Please fill in the online form on the right and press the send-button.

DOWNLOAD PDF VERSION HERE

Where? Please provide the basic fact regarding your location.

Where is your place?

Which direction should I look?

OPTIONAL: Do you have a photo of your place? please upload here

Why? Please let us know why your place is special to you, personally.

Why have you chosen this particular place/landscape?

MANDATORY: Who are you? Please provide a few details about yourself.

Name*

Phone*

email*

Repeat email*

Location/School/Club*

Consent

Do you agree to have the painting of your place dedicated to your name?
Yes
No

Do you consent to have parts of your text reproduced alongside the painting of your place?
Yes
No

Do you agree to have parts your text reproduced in a book to compliment the exhibition?
Yes
No

BY SUBMITTING YOUR “MY PLACE” QUESTIONNAIRE YOU ARE AGREEING TO THE FOLLOWING CONDITIONS:*

• all entrants are asked to share details of their “My Place” in written form.
• all “My Place” locations must be publically accessible, and Rod requests that they are easily accessible
• all entrants, by submitting their “my place”, agree to having Rod’s painting (if chosen) dedicated to their name
• all entrants, by submitting their “my place”, agree to having their words reproduced as part of the exhibition
• all entrants, by submitting their “My Place”, agree to having their words reproduced in a book to be published as part of the exhibition
• all entrants should please note that submitting a “my place” location does not guarantee inclusion, and the final decision lies solely with Rod Coyne

I agree

Thank you for taking the time to fill in the questionnaire. Please type the check word letters in the field below and press the send button.

Check word: