Art in Public Places - Fire Station 92 (Nova Road)
Slide / CD Photo / DVD Photo Identification
City of Ormond Beach and Ormond Memorial Art Museum & Gardens
Artist's Name  
Address  
City, State, Zip  

 

______________________________________________________________________
                                                        City

 

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State

 

________
Zip
Telephone Number #1 

 

(            ) ______ -_______________
 Area Code

Telephone
Number #2

 

(            ) ______ -_______________
 Area Code
Email Address                              
Slide Number  
Title of Work  
Medium

 
Dimensions
(include unit of measure - ft/in/cm/mm) 

Width:

Height:

Length:
Date Completed

Month:                   Day:                   Year:
Location of Work  
Price

   $

Mail form to Public Art Committee c/o OMAM, 78 E. Granada Blvd, Ormond Beach, FL 32176
 OMAM is a U.S. Code Title 26 Section 501(c)(3) non-profit organization, registered with the State of Florida Department of Agriculture and Consumer Services.
Registration Number: SC07333.
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