*Name:

Street Address:

City, State & Zip:

*Daytime Phone:

Email:

*Square Size:

*Have you been a Via Colori® artist in the past?

*Do you have your own square sponsor? (not required)

If so, what is its name?

Do you know someone who might wish to sponsor your square? (not required)

If so, please fill in their name


and telephone number.

Thank your for volunteering your talents as a Via Colori® Artist!

* Required Fields