Are you filling this form as the artist or on their behalf? *

As the artist

On their behalf

First Name

Last Name

Phone

(###)

###

####

Are you a member of Age UK Westminster? *

Yes

No

Age category *

over 80

under 80

How many artworks are you submitting? *

1

2

3

Would you be interested in selling your artworks? *

Yes

No

Are you able to send the artworks in-person or via courier? *

If courier we will email or phone you separately for a home address

In-person

Via Courier

Are you available to attend the exhibition? *

Yes

No

Are you able to attend the Opening Night on Wednesday 1st October 2025?

Yes

No

Are you able to attend the Closing Ceremony on Sunday 5th October 2025?

Yes

No

Are you interested in volunteering for the exhibition?

Yes

No

I give consent for Age UK Westminster to take photographs/videos of me at the event mentioned above. I understand that the resulting imagery will be used to publicise Age UK Westminster events (including our website, social media pages an newsletters) *

Yes

No

I give consent for Age UK Westminster to share these photographs/videos with their funders and potential funders as part of the application and/or monitoring for funding Age UK Westminster has received from them *

Yes

No