Charlestown Township, Chester County, PA

A Survey Seeking Art of Charlestown
(Please share your treasures of Charlestown)

If you haven't read the background information and FAQ, please click here. Please complete all fields in the upper half of this form, and then fill in one item line for each painting you will provide for the show. If you have more than five paintings, please send additional forms.
 
Your Name:
Address:
                   
E-Mail Address:
Telephone:

How many paintings of Charlestown scenes
do you have for this show?  
When displayed, may we identify you
as the owner?   Yes No   (Click "No" to remain anonymous.)

 Comments or questions:
In the form below: Item# 0 is an example. "Photo?" asks whether the Charlestown Historical Society may photograph the painting for its records. "Calendar?" asks whether CHS may use a photo of the painting in a future Charlestown Township calendar. "Dimensions" include the frame, if any.
Item
Num.		 Subject Artist Medium
Oil/Water Color/Ink/etc.		 Date
(year)		 Dimen-
sions
wid x ht		 Photo? Calendar?
0 Brightside Farm with cows from Yellow Springs Road Milo Winter,Jr. Oil 1986 28.5x23 Yes
No
Yes
No
1 Yes
No
Yes
No
2 Yes
No
Yes
No
3 Yes
No
Yes
No
4 Yes
No
Yes
No
5 Yes
No
Yes
No
   A confirmation of receipt of your form will be emailed to you.
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