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STUDENT
NameAddressCity State ZipPhone ( ) E-mail ____________________________ Parents or Guardian Name (printed)
Signature of parent or guardian allowing NACD/District to utilize the poster for educational or promotional purposes:
DateGrade ______ Age
SCHOOL
Teacher School NameAddress Phone (__ )City State ZipE-mail address
CONSERVATION DISTRICT
Name St. Joseph County Soil & Water Conservation DistrictContact Rick Glassman Title Environmental Education Coordinator Address 5605 US 31 South, Ste 4 Phone (574
) 291-7444, ext 3City South Bend State IN Zip
46614
E-mail Address richard.glassman@in.nacdnet.net
St. Joseph County SWCDPoster Contest Entry Form
Attach to back of poster * * * * * *
2010 St. Joseph County SWCDConservation Poster Contest
Posters are due/delivered to the SWCD officeby Friday, April 9, 2010, no later than 3:30 PMQuestions: Contact Rick Glassman by e-mail:richard.glassman@in.nacdnet.net
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