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Seller Application Form

What Membership Level are you interested in?

	Premier Plus

	Premier

	Weekender

	Monthly Membership

Full Name:

Address Line1:

Address Line2:

City:

State:

Country:

Email:

Phone:

Additional Phone:

Education:

Studio Affiliation:

Proposed "Shop" Name:

(e.g. Heather's Pottery)

Shop Image:

How long have you been working in clay?

What is the price range of items you will be selling on potterydaily.com?

What juried shows have you been in?

What galleries have carried your work?

What professional affiliations to do you belong to?

What makes your pottery different from others in the industry?

Do you have a PayPal account?

Yes

Do you have a website?

Yes

How do you think you are going to benefit by being a member of the potterydaily.com community?

Please upload 5 samples of you work