Asian-Pacific Islander Heritage Month Essay Contest Application

APAH_ESSAY-CONTEST
ASIAN-PACIFIC ISLANDER AMERICAN HERITAGE MONTH 2011

Essay Contest Topic:
"Why Is Asian-Pacific Islander Heritage Month Important?"

Entry Application



Date: _____________________________

Name: _____________________________________________

Date of Birth: _____________________________

Street Address: _________________________________________

City, State, Zip: _________________________________________

Phone (Daytime): (_______)______________________

Phone (Evening): (_______)______________________

E-mail: _____________________________

Name of Essay: _______________________________________

________________________________________________________________________________

School: _____________________________

Street Address: _________________________________________

City, State, Zip: _________________________________________

Phone: (_______)______________________

Grade: ______________________

All entries must be received by Wednesday, May 11, 2011 at 11:59 p.m. to be eligible for contest. This completed application form must accompany each essay and photo. Submissions may not be made electronically.

Furthermore, I grant NBC4/WRC-TV the right to distribute my essay and photo as they see fit (except where prohibited), including any broadcast or print reproduction, as well as to utilize my name and likeness for future promotional projects, for a period not to exceed twelve (12) months after 5/30/11.

Signed: __________________________________

Date: _____________________________

Parent's Signature (if under 18): __________________________________

Date: _____________________________

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