Personal tools

Personal tools

Community Photo Contest Form

 

COMMUNITY PHOTO CONTEST

Official Entry Form

 

Category:    Adult,    High School,    8 to 8th grade

(please circle)

 

 

Name

 

 

Address                                                                      City, State, Zip

 

 

Phone                                                                         E-mail

 

 

Photo ID#/File Name

 

 

Photo Caption/Title

 

 

Where was your photo taken?

 

 

What is your photos story?  (optional)

 

 

 

 

 

 

 

 

 

 

I grant permission to use the submitted photograph on the Community Room’s wall and in advertising the community of Ackley in print or online.  I will make no monetary or other claim against the committee for the use and publication of my photograph.

 

 

Signature                                                                                                       Date

 

 

Parent/Guardian Signature (if under the age of 18)                               Date

 

Please submit the completed entry form with each photo by mail to Ackley Public Library 401 State St. Ackley, IA 50601, e-mail to  mailto:ackleypubliclibrary@gmail.com, or delivery to the Ackley Public Library.  Entry Deadline:  Midnight, August 1, 2015.

This resource is supported by the Institute of Museum and Library Services under the provisions of the Library Services and Technology Act as administered by State Library of Iowa.