Do you currently reside in Ohio? *

Yes

No

Hayley Gallery works on a consignment basis only, are you willing to agree to this condition? *

Yes

No

If you are accepted into the gallery we require you to visit once every three months to update or exchange inventory. Are you able to meet this requirement? *

Yes

No

If you are accepted into the gallery are you willing to agree to a 15 mile exclusivity from zip code 43054. *

Yes

No

Name *

First Name

Last Name

Phone *

(###)

###

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Which medium do you work in? *

Acrylic

Oil

Metal

Glass

Jewelry

Mixed Media

Wood

Fiber

Sculpture