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© Copyright 2004  Mailing List Form   Galerie Lieve Hemel, Amsterdam


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A
	Mr.    Mrs.
Initials
First name
Last name
(Company)
Street
Postal code
City
State - Country
Telephone
Fax
E-mail
The gallery sends out five mail shots a year, by regular post or, by way of exception, via E-mail. How would you like to receive our mail shots?	By post      Via E-mail      Both
If you have recently moved house, please fill in your old address in the space below:
Old address
Old postal Code
Old town or city
With effect from/Since
B Although you are under no obligation whatsoever to answer the questions below, if you were to consider purchasing a work of art by one of the artists, perhaps at some point in the future, the information could be as useful to us as it would be to you, in that it would make it easier to satisfy your requirements. We would - perhaps unnecessarily - stress that our policy calls for the utmost reserve on our part. It is only upon your explicit request that we will approach you with supplementary information, which of course for you comes with no strings attached.
Which of the artists has (have) your preference? To select more than one artist, keep the CTRL key pressed down while clicking the names of your choice.	Jan van den Berg  At Brandenburg  Hendrick Brandtsoen  Roger Braun  Bernard Brunklaus  Anneke van Brussel  Carolien Cuyvers  Georges Cuyvers  Tom Eckert  Erik van der Esch  Goudji  Rudolf Hellebaut  Andrew Hemingway  Jef Huibers  John Kalb  Hans van der Kroef  Walter Leclair  Livio de Marchi  René Mikovic  C.B. Muller  Jan van Nouhuys  Olav Cleofas van Overbeek  Paul Pallandt  Peter van Poppel  Francisco Roa  Nicolas van Ronkenstein  Herman van Rossum  Johan Scherft  Jurriën Schiff  Hester Schroor  Annabelle Six  Silver  Karel Sirag  Ben Snijders  Silvina Spravkin  Bernard Verkaaik  Theo Voorzaat  Alex de Vrede  Wijnand Warendorf  Els van Westerloo  Karel Wiggers  Zilver
Have you previously seen work by the artist(s) of your choice? If yes, where? (More than one selection possible)	Yes      No      At the gallery      On this web site      In a magazine, journal or newspaper      At someone else's home or business      At an art fair or elsewhere
Does the web site clearly tell you which works are still available?	Yes      No
Would you like us to provide you with supplementary information on the available works?	Yes      No    If yes, below please tick the artist(s)    of your choice.
Please feel free to use the space below to ask any other questions you may have (e.g. dimensions of particular works, subject matter, colours, etc.)
Would you like us to advise you, by telephone or via E-mail, of the arrival at the gallery of new works by the artist(s) of your choice?	Yes      No
Is it possible for you to download (or copy) images from our web site?	Yes      No
Your preferred language of correspondence:	English  ( French German)

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