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    Student Entry Form

    Uploaded by

    Roi Trawon
    This document is a student entry form for a PTA Reflections program. It collects information about the student, their artwork, including title and details. It also obtains signatures to grant permission to display the student's work and accept the program's rules. The form requests the PTA and student names, contact information, grade, artwork category and details, and a short statement about how the work relates to the theme.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Student Entry Form

    Uploaded by

    Roi Trawon
    27 views1 page
    This document is a student entry form for a PTA Reflections program. It collects information about the student, their artwork, including title and details. It also obtains signatures to grant permission to display the student's work and accept the program's rules. The form requests the PTA and student names, contact information, grade, artwork category and details, and a short statement about how the work relates to the theme.

    Original Description:

    ref

    Original Title

    PTA

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    © © All Rights Reserved

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    This document is a student entry form for a PTA Reflections program. It collects information about the student, their artwork, including title and details. It also obtains signatures to grant permission to display the student's work and accept the program's rules. The form requests the PTA and student names, contact information, grade, artwork category and details, and a short statement about how the work relates to the theme.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    27 views1 page

    Student Entry Form

    Uploaded by

    Roi Trawon
    This document is a student entry form for a PTA Reflections program. It collects information about the student, their artwork, including title and details. It also obtains signatures to grant permission to display the student's work and accept the program's rules. The form requests the PTA and student names, contact information, grade, artwork category and details, and a short statement about how the work relates to the theme.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Student Entry Form

    To be completed by PTA before distribution

    FULL PTA NAME: COUNCIL _______________________________ _________DISTRICT# __________________ STATE_________


    PTA/PTSA: _______________________________ NATIONAL 8-DIGIT ID # __ __ __ __ __ __ __ __ _
    REFLECTIONS CHAIR NAME: ___________________________________ EMAIL: ________________________________________
    PTA ADDRESS: ______________________________________________ PHONE: ________________________________________
    Local PTA good standing status:
     Membership dues paid date __________

    ____________________________________________________________________________________________________________

    STUDENT NAME: ______________________________________________________ GRADE: _______ AGE:_______ M/F: _______

    MAILING ADDRESS: ___________________________________________________________________________________________

    CITY: ______________________________________________________________ STATE: _______________ ZIP: _______________

    PARENT/GUARDIAN NAME(S): __________________________________________________________________________________

    PARENT/GUARDIAN PHONE: _________________________________________ E-MAIL: ___________________________________

    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.

    _________________________________________ _______________________________________________________
    Signature of student Signature of parent/legal guardian (required if child is under 18 years)

    JUDGING INFORMATION

    GRADE DIVISION (Check One) ARTS CATEGORY (Check One)


     PRIMARY (Preschool- Grade 2)  HIGH SCHOOL (Grades 9-12)  DANCE CHOREOGRAPHY  MUSIC COMPOSITION
     INTERMEDIATE (Grades 3-5)  SPECIAL ARTIST (All Grades)  FILM PRODUCTION  PHOTOGRAPHY
     MIDDLE SCHOOL (Grades 6-8)  LITERATURE  VISUAL ARTS

    TITLE OF ARTWORK: __________________________________________________________________________________________

    ARTWORK DETAILS: (Dance/Film: cite background music; Music: musician(s)/instrumentation; Literature: word count; Photo/Visual
    Arts: materials & dimensions) ___________________________________________________________________________________

    ARTIST STATEMENT: (At least 10 words, 100 words max describing how your work relates to the theme)

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