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2012 Mobile Masterpieces Art Donation Form

Thank you for your interest in donating original artwork to the Montgomery College Alumni Association's (MCAA) art raffle to benefit its alumni scholarship programs. Please provide information about yourself and the artwork you are donating, and execute the transfer and release statement below.

Donor Information      
City:    State:                  Zip:   
Telephone:               Email Address:  
I am:    
  Provide a brief artist biography for inclusion in the program catalog. 


Note:  This may be edited. 

Artwork Information

Title of Donated Artwork:   
Size         Fair Market Value  $       Year Piece Created    

Provide a brief description of the artwork or the inspiration behind the artwork for inclusion in the program's catalog


Note:  This may be edited.     


Property Transfer and Information Release

I, the undersigned, certify that the artwork described above is my own creation, and that I am the sole owner of the said artwork and all creative rights thereto.  I hereby transfer the said artwork and non-exclusive rights to the Montgomery College Alumni Association.  I understand and agree that my biographical information, as well as information about my art, will be posted in the Association's online program catalog and related materials. 

Artist's Full Name  


Montgomery College

Montgomery County, MD


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