2017 Congressional Art Competition Submission Survey

To enter the Congressional Art Competition, (1) please submit the form on this webpage, and (2) email a picture of the original artwork to Gottheimer.Arts@mail.house.gov by Thursday, April 17, 2017.

All works must be no larger than 26” x 26” x 4” including the frame, must weigh no more than 15 pounds including the frame, and art work must be ready to hang.

Incomplete submissions will not be considered.

First Name

Last Name

Email Address*

Home Address

Street 1 Street 2 City State Zip

Home Phone () -

Grade

High School Name

Name of Art Teacher

School Telephone Number

Entry Title

Medium

Parent/Guardian Name(s)

Parent/Guardian Email Address

Parent/Guardian Telephone Number () -

I hereby certify that, to the best of my knowledge, the art entry described above is an original work of authorship and that it is not copied from, nor does it include, any other person’ copyright work.

YesNo

If selected, I agree to display my artwork in the Gottheimer office or US Capitol for up to one year.

YesNo

I represent that the art entry described above is an original work of authorship personally created by the undersigned student to which the student is entitled copyright protection. In consideration for the acceptance of the art entry by the Member of Congress designated above in An Artistic Discovery (the Congressional Art Competition sponsored by the U.S. House of Representatives) and intending to be legally bound hereby, the undersigned grant the Member and the House the right to publicly display the art entry, if it is selected for display, in accordance with the rules of the Art Competition, for a period of two years from the latest date on this form. The undersigned acknowledge that the final decision regarding the suitability of an art entry to be displayed in the Capitol will be made by a House panel chaired by the Architect of the Capitol. The undersigned also grant the Member, the House, their employees and agents, and the United States the right to reproduce the art entry for any non-commercial purpose. The undersigned further grant the Member, the House, their employees and agents, and the United States.

YesNo

By filling out this form, you will begin the application process to the 2017 Congressional Art Competition and begin receiving Congressman Gottheimer's weekly email update.

Please remember to submit your artwork by emailing a picture of the original artwork to Gottheimer.Arts@mail.house.gov.