PLATFORM REGISTRATION FORM

PLATFORM REGISTRATION FORM
Name of Municipality, Foundation, Business, Property*
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail*
Website
WE ENTHUSIASTICALLY PROVIDE FOR ‘IN SITU’ ART:

SITUATED NEAR THE LIGHT MERIDIAN LINE 3°7’45” E
A Piece of Land
A Space or Building
A Service
Other
Should be Empty: