Form GSA-7437 Art-In-Architecture Program National Artist Registry

ART-IN-ARCHITECTURE PROGRAM
NATIONAL ARTIST REGISTRY

OMB Number: 3090-0274
Expires: 7/31/2009

(See Privacy Act Statement on Reverse)

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. General Services Administration,
GSA Public Buildings Service, Center for Design Excellence and the Arts (PMB), 1800 F Street, NW, Washington, DC 20405.

INSTRUCTIONS: Return this form with a current resume and up to 20 digital images of the artist's work created within the last five years to the
address below. Please use jpeg format 10 x 7.5 inches at 72dpi. On a separate sheet, for each image please include the name of artist, title
of work, date, medium/materials, and dimensions.
U.S. General Services Administration
Art-In-Architecture Program
1800 F Street, NW
Washington, DC 20405

YES

DISCLOSURE OF INFORMATION ON THIS FORM TO RESEARCHERS, ART PROFESSIONALS, AND MEMBERS OF THE PUBLIC
NAME

DATE OF BIRTH

STREET ADDRESS

PLACE OF BIRTH
STATE

CITY

ZIP CODE

NO

ARTIST'S WEBSITE

E-MAIL ADDRESS
HOME PHONE NUMBER

WORK/STUDIO NUMBER

FAX NUMBER

GALLERY OR REPRESENTATIVE
U.S. CITIZEN

MEDIA (Check as many as apply)

YES

PAINTING

GRAPHIC

TEXTILE

NO

SCULPTURE

ARCHITECTURAL ARTS

POETRY

ACRYLIC
ALABASTER
ALUMINUM
BRONZE
CANVAS
CAST STONE
CERAMIC
CHARCOAL
COMPUTER GRAPHICS
CONCRETE
COPPER
COR-TEN STEEL
ENAMEL
ENCAUSTIC
ENVIRONMENTAL/EARTH
FIBER
FIBERGLASS

MATERIALS (Check up to six)

FRESCO
GLASS
GRANITE
GRAPHITE
INK
LACQUER
LIGHT
LIMESTONE
LINEN
MARBLE
METAL
MIXED MATERIALS
MOSAIC
OIL
PAPER
PASTELS
PENCIL

OTHER (Specify)

PHOTOGRAPH
PLASTER
POLYMER
RESIN
STAINED GLASS
STEEL
STONE
STUCCO
TEMPERA
TERRA COTTA
TILE
WATER
WATER COLOR
WOOD
VIDEO
OTHER (Specify)

REMARKS

GENERAL SERVICES ADMINISTRATION

GSA 7437 (REV. 6/2008)

PRIVACY ACT STATEMENT
Submission of all personal information listed on the reverse of this form, i.e., address, and date and place of birth, is
voluntary, and will not be used as selection criteria in awarding commissions through the Art-In-Architecure Program.
The failure to provide an address or phone number, however, would make it impossible to contact you. The primary
use of the personal information you provide is to compile statistics to ensure that the pool of artists the Federal
Government considers for commissions is sufficiently diverse and representative of the United States. It is collected
under the general authority granted to GSA under the Federal Property and Administrative Services Act of 1949
(40 U.S.C. 471 et. Seq.) and the Public Buildings Act of 1959 (40 U.S.C. 601-616).
Information on this form may be disclosed to a Member of Congress in response to an inquiry made on your behalf.
Information may be disclosed to researchers, arts professionals, and members of the public for on-site inspections
upon request. Information may also be shared with a court or adjudicative body when GSA, or a GSA employee, or
the United States is party to litigation and the record is relevant, necessary, and compatible with the purpose of
collecting the information. Finally, information on this form may be disclosed to an appropriate Federal, State, or
local agency responsible for investigating, prosecuting, or enforcing a statute, rule, regulation or order if GSA
becomes aware of any actual or potential violation of a statute, rule or regulation.

GSA 7437 (REV. 6/2008) BACK