CAMPUS ART WALK FORM

Name: ____________________________________________

Date: _____________________________________________

Department: _______________________________________

Mail Code: ________________________________________

I viewed the following pieces of art (please list title, artist, and building):

Ex: Wooster Sauce by Muriel Weezentoasten; HHS Building

1.  _________________________________________________________________________

2. _________________________________________________________________________

3. _________________________________________________________________________

4. _________________________________________________________________________

5. _________________________________________________________________________

6. _________________________________________________________________________

7. _________________________________________________________________________

8. _________________________________________________________________________

9. _________________________________________________________________________

10. ________________________________________________________________________

My favorite piece was: _________________________________________________________

Because:_______________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Please return to Mary Cusack at MC 5100 for signature.  This form will be returned to you so that you can submit it with your Wellness Rewards Program form.

Verified by:____________________________________   Date: ______________________