Section 1 of 5
Mann 2023-2024 Reflections Student Entry Form
Please fill out all information. If you have any questions, please contact Mann PTA at teammannpta@gmail.com.
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Student First Name
Student First Name
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Student Last Name
Student Last Name
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Grade
Grade
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1.
K
2.
1
3.
2
4.
3
5.
4
6.
5
7.
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Age
Age
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and
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Classroom
Classroom
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Parent/Guardian Name
Parent/Guardian Name
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Parent Cell Phone (format: 111-111-1111)
Parent Cell Phone (format: 111-111-1111)
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Mailing Address
Mailing Address
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City
City
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State
State
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Email
URL
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Zip
Zip
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Ownership
Ownership
Ownership in any submission shall remain the property of the entrant, but entry into this program constitutes entrant’s irrevocable permission and consent that PTA may display, copy, reproduce, enhance, print, sublicense, publish, distribute and create derivative works for PTA purposes. PTA is not responsible for lost or damaged entries. Submission of entry into the PTA Reflections program constitutes acceptance of all rules and conditions. I agree to the above statement and the National PTA Reflections Official Rules.
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Student Signature (type your name as your electronic signature)
Student Signature (type your name as your electronic signature)
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Parent/Guardian Signature (type your name as your electronic signature)
Parent/Guardian Signature (type your name as your electronic signature)
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Title of Work
Title of Work
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Details/Specifications: Include word count for literature. List dimensions for photography/visual arts.
Details/Specifications: Include word count for literature. List dimensions for photography/visual arts.
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Artist Statement (In 10 to 100 words, describe your work and how it relates to the theme)
Artist Statement (In 10 to 100 words, describe your work and how it relates to the theme)
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Grade Division (choose one)
Grade Division (choose one)
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Primary (Pre-K-Grade 2)
Intermediate (Grades 3-5)
Special Artist (All Grades)
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Arts Category (choose one)
Arts Category (choose one)
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Literature
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Photography
Continue to next section
Visual Arts
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Section 2 of 5
Literature
VERY IMPORTANT: Before uploading, please name your file according to this format:
School-DIVISION–LIT–Last Name
For example: Mann-PR-LIT-SMITH.PDF
For example: Mann-PR-LIT-SMITH.PDF
Division Initials: PR (Primary grades K-2), INT (Intermediate grades 3-5)
Literature - Upload document as a PDF (can be handwritten & scanned or typed).
Literature - Upload document as a PDF (can be handwritten & scanned or typed).
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10
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Section 3 of 5
Photography
VERY IMPORTANT: Before uploading, please name your file according to this format:
School-DIVISION–PH–Last Name
For example: Mann-PR-PH-SMITH.PDF
Division Initials: PR (Primary grades K-2), INT (Intermediate grades 3-5)
Photography - Upload photo.
Photography - Upload photo.
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1
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10
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1 MB
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Section 4 of 5
Visual Arts
VERY IMPORTANT: Before uploading, please name your file according to this format:
School-DIVISION–VA–Last Name
For example: Mann-PR-VA-SMITH.PDF
Division Initials: PR (Primary grades K-2), INT (Intermediate grades 3-5)
Visual Arts - Upload photo of artwork. For 3D artwork upload 3 photos of the entry (a combination of angles).
Visual Arts - Upload photo of artwork. For 3D artwork upload 3 photos of the entry (a combination of angles).
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1
5
10
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1 MB
10 MB
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1 GB
10 GB
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Section 5 of 5
Please make sure to hit the "Submit" button below. You will receive an email confirming the receipt of your submission. Thank you for participating in the Reflections Program.
Please contact your school Reflections Chair if you have any questions.
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