Application for Procurement

BIOGRAPHICAL INFO

Full Name

City and Country of Primary Residence

Email

Telephone #

Profession / Primary Life Activity

PETITION FOR OWNERSHIP

Series

Selected Work

Explain what draws you to this work. Include mental impressions, feelings, resonance with personal life experience, and your reason for desiring ownership.

List other important works of art (both work and artist) that you currently own. Please give a brief summary of what each work means to you and the circumstances surrounding procurement.

Provide a brief description of the greatest personal obstacles or challenges you are faced with in your life, currently. Describe the ways in which these challenges limit you, mentally or physically, and how you would imagine your life to be without them. In the unlikely event you are not dealing with any significant limitations in life, consciously or otherwise, list external events, other people, or groups that affect you in a significant way and the psychological effect they have on your everyday life.

Were you to be completely free of limitation, realizing your most optimal, fully actualized form in both body and mind, what would you accomplish in this life?

Do you believe that the human world can evolve and realize freedom from the burdens of biological evolution, achieving peace and harmony? If so, please explain how humans would live in such a world. If you do not believe in such human potential, please state, in as much detail as possible, your reasons.

I have read the privacy policy and agree to its terms in full.

I understand that procurement rights are not guaranteed by submitting this petition. Mind Pervasion Gallery deserves the right to deny a petition at any time and for any reason, so long as those reasons are not discriminatory of race, gender, class, religion, sexual orientation, or belief. Should an additional follow-up interview by teleconference be required to clarify details, I agree to comply with all necessary requests. As a potential buyer, I understand the serious commitment of finances, energy, and mindfulness required for ownership and will do everything possible to ensure the protection and proper handling of this artwork.