Test | Fund for the Arts

Submit Artwork Form

If you are interested in submitting artwork to be considered for display at the Novak Center for Children’s Health, please fill out the following form and upload a picture of your art. The Art in Healthcare Art Selection Committee, made up of healthcare professionals, art professionals, community members and development staff, will review all submissions for approval.

Name*
First Last
Phone*
Email*
Age*
School (if applicable)
If applicant is under 18, parent or guardian please complete:
First Last Phone Email
Art Medium*
Tell us a little about the artist:*
(Are you a professional artist, an aspiring student, what is your background/interest in art):
Tell us a little about the artwork:*
(description of the piece, what inspired it, etc.)
Are you connected to the Novak Center for Children's Health?*
- Patient
- Parent, guardian or family member
- Healthcare Provider
Do you or anyone in your life have Type 1 Diabetes?*
- Yes
- No
I give Fund for the Arts, Novak Center for Children's Health and the Lift a Life Foundation permission to review and use this artwork.*
- Yes
Upload a photo of your artwork*
Accepted file types: jpg, gif, png, pdf.
CAPTCHA