Please fill out, keep a copy for your records, and attach a copy to an e-mail addressed to me at bella@renaissancewoman.net

Your Details

Your Name	
Your location (eg Adelaide, South Australia, Australia)	
E-mail address for communication purposes	
Alternate E-mail address (in case of failure of primary e-mail address)	
SCA name (if applicable)	
SCA Kingdom/Local Group if applicable (eg Kingdom of Lochac, Barony of Innilgard)	
SCA Title if applicable (eg, Lady, Honourable Lady, Mistress etc)	

Details of Your Costume/Garb Item/s

Which of Italy’s city-states does this item/s represent?	
Which decade/s of the period 1490-1600 are being attempted in this item/s?	
Is this item/s an attempt at re-creating clothing from a portrait or other period image? (If  ‘yes’ please list artist/date and attach a copy to your e-mail)	No/Yes -
If this item/s is NOT an attempt to re-create the clothing in a particular portrait/other period artwork, please choose one portrait/artwork that represents your prime inspiration and list artist/date and attach copy to your e-mail. (Alternatively, if you have a design drawing and would like to send that instead, please attach to the e-mail)	Details of Inspiration Image:
Is this item or outfit fully completed at this time? (If no, please give estimate for completion)	Yes/No
Is there a particular month in which you would like to be Showcased? (I will do my best to accommodate you)	

Permissions
I give permission for my full name to be published on The Italian Showcase	Yes/No
Name preference – legal or SCA name?	Legal/SCA
I give permission for my primary or alternate e-mail address to be published 	Yes/NoPrimary/Alternate
I give permission for my location to be published	Yes/No