LOAN AGREEMENT FORM

EFA Robert Blackburn Printmaking Workshop

323 W. 39th Street
New York, NY 10018

Essye Klempner, essye@efanyc.org

Exhibition

2024 KAHN MASON SIP Fellowship

June 7 - July 13, 2025

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Blackburn Study Center

323 W. 39th Street, 2nd Floor
New York, NY 10018

By completing and submitting this form you are signing the Loan Agreement as a contract between the artist and EFA Robert Blackburn Printmaking Workshop.

Details
• Work will only be accepted at the printshop between DROP OFF – June 1 - 4 from 12-7pm.
• If any work requires special installation it is the artist's responsibility to ship/deliver instructions and special hardware or essye@efanyc.org
• All sales will go through the artists or their gallery with a request of 20% donation to EFA.
Mail or drop off work at EFA RBPMW 323 West 39th Street New York, NY 10018 - with return shipping.

PART I

Personal Information

Date

YYYY

Name

First Name

Last Name

Phone Number

Pronoun

Email Address

PART II

Title of Work

Year

Medium

Dimensions

Edition Number

Insurance value

Is your artwork for sale?

Yes

Sale price

Courtesy of

PART III

Instagram handle/socials

Conditions Governing Loans

1. Attributions, dates, and other information shown on the face of this Loan Form are as given by the Artist. Any valuations or prices shown are those stated by the Artist are not to be considered as appraisal by EFA Robert Blackburn Printmaking Workshop. 2. EFA Robert Blackburn Printmaking Workshop reserves the right to reproduce the artwork loaned for any publication or publicity related to the exhibition unless specified above. This includes any accompanying catalogue, brochure, photographs or digital media for publicity purposes. 3. The aforesaid conditions shall apply to all objects sent to EFA Robert Blackburn Printmaking Workshop on loan and cannot be altered, changed, waived, or otherwise affected except by written consent of EFA Robert Blackburn Printmaking Workshop. SALES Artist will be given 100% of sales. Donations to EFA RBPMW is highly encouraged.

Yes, I have read and consent to Conditions Governing Loans of my artwork.