The Ukrainian Museum 222 East Sixth Street (bet. 2nd & 3rd Aves.) New York, NY 10003 Wed. thru Sun. 11:30AM-5PM (212) 228-0110 e-mail: info@ukrainianmuseum.org * www.ukrainianmuseum.org

Click here to print this page; fax to 212.228.1947 

DATE _______________

____________________________________________________________________________
NAME
____________________________________________________________________________
ADDRESS
____________________________________________________________________________

____________________________________________________________________________
CITY, STATE/PROVINCE, ZIP/Postal Code                            Country

(______)____________________________   _____________________________________
TEL                                    EMAIL

Enter the maximum amount you are willing to pay for the item (US$ only):

$_______ Alexander Archipenko, Encounter       $_______ Lidia Piaseckyj, Angel

$_______ David Burliuk, Santa Monica           $_______ Natalia Pohrebinska, Three Faces

$_______ Jacques Hnizdovsky, Geranium          $_______ Romana Rainey, Umbrellas

$_______ Jacques Hnizdovsky, Publicity         $_______ Christina Saj, Guardian Angel of the Garden

$_______ Jacques Hnizdovsky, Periwinkle        $_______ George Saj, Fat Cat
     
$_______ Ivan Marchuk, TBA                     $_______ Tamara Skrypka, Apples
     
$_______ Alexander Motyl, Untitled             $_______ Valeriy Skrypka, Between Two Mirrors
     
$_______ Zenowij Onyshkewych, TBA              $_______ Ilona Sochynsky, Journey's End
     
$_______ Arcadia Olenska-Petryshyn, Grasscape  $_______ Marta Hirniak-Voyevidka, Scent of Spring
    
$_______ 2 round-trip tickets New York-Kyiv    

     
Payment type (check one):
[  ] Check payments are preferred. Objects will be available for pickup after check is cleared.

[  ] Your credit card will be charged only if yours is the winning bid.
     CHECK ONE:     [ ] VISA   [ ] MASTERCARD

     #_____________________________________   Exp. date: ____________ 

     Name on credit card (print): ___________________________________  

     Signature ______________________________________________________

An auction representative will execute your bid for you. The maximum bid will be entered
only if bidding reaches that amount. If the absentee bidder's amount is not reached, the item
will go to the bidder for the lowest bid necessary to win the auction, up to, but not
exceeding the absentee maximum bid. The Museum is not responsible for inadvertently failing
to execute bids or for errors relating to the execution of bids. All items are sold "as is."

Please enter your name and sign:
I, _____________________________, recognize this form as a binding agreement to
purchase the above item(s) at the amount(s) indicated.

Signature ________________________________________________________

The Ukrainian Museum is grateful for your generous support!