About your submission

How many tiles are you submitting *

1
2
3
4 or more

Please tick the relevant aspects that apply to your experience/s *

If you selected other and would like to share, please do so here.

Title of Piece (Optional)

Optional - What is the inspiration for your piece/s. Feel free to share as little or as much as you would like about your story.

Are you happy for me to share your story ?

Yes, for exhibition purposes only
Yes for exhibition, social media and other purposes listed in section 3 of the Terms and Conditions of this project
No, please don't share this.

Are you happy for me to share your print ? *

Yes, for exhibition purposes only
Yes for exhibition, social media and other purposes listed in section 3 of the Terms and Conditions of this project

Optional - When did you give birth/support a birth (you can select multiples)

Declarations

I confirm this carving is my own original work, and I have not copied it from another artist or source I do not have rights to use.

I have read and agree to the attached Terms & Conditions, including the licence granted to the Artist to reproduce and exhibit my work as part of the collective artwork.

I consent to my name and submission details being held for the purposes of this project, as described in the Terms & Conditions.

I am happy for my piece to be considered for use on fabric, promotional materials, or other products connected to the project (see Section 3 of the Terms & Conditions).

If you leave the box above unticked, your piece may still be included in exhibitions and online, but will not be used for the additional purposes listed in Section 3 unless you separately agree.

Signature (contributor, or parent/guardian if under 18): *

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Submission Form - Held/NotHeld

Contributor Details:

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