Student Entry Form 2018-2019

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INSPIRATIONS ENTRY FORM

“The World We Could Make”

2018-2019

Student must complete the entire form. Student and parent must sign the bottom. You may use the back of this form for more writing space.

Category

School:______________________________
Grade Division: K-2.  3-5.   6-8.   9-12 Grade: (Circle One)

(Check One)_____Literature_____Visual Arts _____Photography_____Musical Composition_____Theatre_____3-D Art _____Film/Video _____Choreography/Dance. ______Graphic/Digital Arts

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Title of your entry:_____________________________________________________

What inspired you to do this project?________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Phone:_____________________ E-mail address:__________________

Student’s First Name:_____________________________________________________

Student’s Last Name:_____________________________________________________

I affirm that this is my original work, created for INSPIRATIONS 2017-2018.
I give the State Inspirations Board my permission to share images of my work on the Inspirations Website and Facebook Page. (If you do NOT want images shared, please mark this line out.)

_____________________________________ Student’s signature

 ______________________________Parent’s/legal guardian’s signature