Essay Contest Entry Form

Name: ____________________________________
Age: _________
Phone Number: _____________________________
Email Address: _____________________________
School: ___________________________________
Grade: __________________
Parent Signature: ____________________________
Participant Signature: _________________________
Please indicate below which prompt(s) you have selected:

____ Prompt 1: H.E.A.R

____ Prompt 2: Overcoming A Situation
____ Prompt 3: Summer Camp Memory
____ Prompt 4: Advice to Younger Self