____________________________________ _______________
(Name of Teacher - Contact Person) (Grade(s) Level)
__________________________________________________________
(Name of School or Organization)
__________________________________________________________
(Street Address or P. O. Box)
__________________________________________________________
(City) (State) (Zip)
________________________________ _____________________
(Telephone - Area Code and Number) (E-mail Address)
__________________________________________________________
(Time for Use)
__________________________________________________________
(Date Packet will be Shipped Back or Returned)
Shipping & Handling Instructions:
Office and Gallery Hours: 9 to 11 a.m. and 1 to 5 p.m., Monday through Saturday,_______
Will pick up packet and return to Gallery
(no cost for handling or postage)_______
Packet is to be mailed to the above address
($10.00 cost for handling and postage)
and Sunday from 1 to 5 p.m.
If you have a question, please let the Sandzén Gallery know.
Telephone: 785-227-2220
Fax: 785.227.4170
E-Mail: fineart@sandzen.org
Birger Sandzén Memorial Gallery, P. O. Box 348, Lindsborg KS 67456-0348
Upon receipt of your e-mail or fax schedule form for Portfolio,
the Gallery will confirm your scheduling by telephone within 3 to 5 days.
This Form may also be mailed to the Gallery for processing.
If you do not receive confirmation, it will be necessary to resubmit your scheduling form.