Area 1 Agency on Aging - 2017 PHOTO CONTEST - Entry Form
A1AA is looking for a community photo to be the cover of next year’s Senior Information Guide, 2018-2019. The guide is distributed all throughout Humboldt and Del Norte counties. One winner will receive a $50 Safeway Gift Card.

*Include a written consent form of any people in the photo*

Contest Guidelines:
 Photos can be of people, places, or things from Humboldt or Del Norte counties (photos of people must include their written consent).
 Photos must be in high resolution (over 300 dpi) and in jpg format (Art can also be accepted in this format)
 The winning photo will be chosen by the editing committee.
 Entries are accepted from August 10 to September 1.
 Entry forms are available online at or by visiting the A1AA office.
 Winner will be announced on the A1AA website on September 15.

Other Rules:
• No purchase necessary
• Participants must live in Humboldt or Del Norte Counties
• Participants must be 60 or older
• One entry per person
• Current A1AA employees are not eligible to participate

A photo credit will be added to the publication unless opted out.

Area 1 Agency on Aging
434 7th Street
Eureka, CA 95501

Email address
Your answer
Your answer
Phone Number
Your answer
What is your age?
Your answer
Photo Title
Your answer
Photo Description
Your answer
If the photo is of a person/people, do you have their written consent to use their likeness?
May we give you a photo credit in the guide with your name?
If yes to the last question, how would you like your name to appear?
Are you currently employed with the Area 1 Agency on Aging?
By submitting this form; I certify that I have the rights to the submitted photo and am allowing Area 1 Agency on Aging to use it. I agree to the rules of this contest and certify that the information entered on this form is accurate and correct.
Please complete the captcha before submitting the form.
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