Shelter for Help in Emergency Use of Artwork Release Form
October is nationally recognized as Domestic Violence Awareness Month. This art contest was created as a way for the Shelter to get the youth in our community involved in the work we do to make every home a safe home – free from violence.
The first portion of this form is to be filled out by the artist submitting their work. If the artist is under the age of 18, the second portion of the form is to be filled out by the parent/guardian of the artist.
For more information, please contact the Prevention Services Coordinator via email at
or call 434-963-4676 ext. 110
Shelter for Help in Emergency
P.O. Box 1013
Charlottesville, Virginia 22901
Hotline: (434) 293-8509
Administrative Office: (434) 963-4676
Sign in to Google
to save your progress.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service