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Champion Registration - WV Poetry Out Loud
DEADLINE FOR SUBMISSION: January 28, 2022
Complete and return this form immediately following your school competition.
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School or Organization *
Teacher's Name *
School Champion's Name *
Champion's Current Grade Level *
Required
Name of Champion's Parent or Guardian *
Parent or Guardian Phone Number *
Parent or Guardian Email Address *
Mailing Address of Champion (Number and Street) *
Champion's City *
Champion's State *
Champion's ZIP Code *
Champion's Phone *
Champion's Preferred T-Shirt Size
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Important and time-sensitive contest information will be shared via e-mail.
Champion's Email Address *
Confirm Champion's Email Address *
POEM SELECTION
READ THIS INFORMATION CAREFULLY:
The order in which poems are submitted is the order in which they will be performed or viewed by the judges. No changes will be permitted.
Poems must be selected from the Poetry Out Loud anthology, either the online or print edition - no exceptions. Make sure poems are selected from the most recently updated anthology.
At least one poem must be 25 lines or less; at least one poem must be pre-20th century. One poem can satisfy both requirements, and may be the student’s third poem.
Refer to www.poetryoutloud.org for rules, eligible poems, and tips on poem selection and performance.

Poem One Title *
Poem One Author *
Is Poem One Pre-20th Century? *
Is Poem One 25 lines or less? *
Poem Two Title *
Poem Two Author *
Is Poem Two Pre-20th Century? *
Is Poem Two 25 lines or less? *
Poem Three Title *
Poem Three Author *
Is Poem Three Pre-20th Century? *
Is Poem Three 25 lines or less? *
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