= Required Fields Online Form - Lightbox Gallery Exhibition Opportunity Use this form to register your interest in an exhibition opportunity in the new Post Office Lane Lightbox Gallery. Save Your Progress You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address. Email Address: Password: Note: Incomplete forms are kept for a period of 2 day(s) , after this time the system will automatically delete your response. Artist Details Artist/Group Name: * Primary Contact Name: * ABN (if applicable): Phone (mobile preferred): * Residential/Business Address: * E-mail Address: * Website (if applicable): Are you a resident of the Midwest Region? * YesNo Age Group * Under 18*18 years and over *If under 18: I provide consent for my child to apply for this exhibition opportunity. Parent Name: Exhibition Details Name of Exhibition (Optional): If group exhibition, identify all artists: Exhibition Description (Provide a detailed description of the exhibition you wish to present): * New or existing work? * I wish to develop new artwork for this exhibitionI will display an existing body of work in this exhibition Predominant Medium (i.e photography, digital artwork, watercolour etc): * Artwork Mockups (upload 1-5 images) * Additional mockup image 2 Additional mockup image 3 Additional mockup image 4 Additional mockup image 5 Supporting Documents Please upload up to 5 images of your previous work (max 5) Additional image 2 Additional image 3 Additional image 4 Additional image 5 Please upload your CV or other supporting documents if applicable (max 3) Terms and Conditions Click here to view the Terms and Conditions. Have you read and accepted the Terms and Conditions? * Yes Get Audio CodeType the code from the image Save & Exit