2019 LEAF Poetry Contest Entry Form
Deadline for Submissions: Friday, April 12th, 2019 - Email to
LEAFArtandpoetry@gmail.com
- MUST BE EDITABLE, not a PDF.
One poem from each poet will be published in a free booklet unless a poet requests not to be included.
Contact Carol at 607-432-0090 x106 or
LEAFArtandpoetry@gmail.com
or visit Facebook.com/LEAFArtContest
* Required
Name
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Your answer
Age Category - choose one.
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I am 18 or over.
I am under 18.
If under 18, please provide parent/guardian name and email address here
Your answer
Address
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Your answer
City
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Your answer
State
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Your answer
Zip
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Your answer
Phone Number
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Your answer
Email
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Your answer
By entering the contest, participants agree to provide LEAF, Inc. with publication rights to all winning poetry for the purposes of addiction prevention.
*
Yes
No
Required
Entry #1 Title:
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Your answer
Entry #2 Title:
Your answer
Entry #3 Title:
Your answer
Please check the statements below to indicate you have read and agree to them.
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I certify that this poetry is 100% my own original work and does not contain any material that is under any copyright restrictions whatsoever.
I have emailed my artist statement and/or bio to
LEAFArtandpoetry@gmail.com
(This is optional, but encouraged.)
I have read the 2019 LEAF Poetry Contest Guidelines Document and understand them.
Required
Type your name here as your electronic signature.
*
Your answer
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