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NCW Poster Contest Entry Form

2010 BEHIND THE SCENES WITH CHEMISTRY POSTER CONTEST ENTRY FORM

Please fill out this form, print, and attach to the back of the posters. All fields are required. Incomplete forms will invalidate the entry.

Student’s Name

Grade

Parent/Guardian

School or sponsoring group

(e.g. Boys and Girls Club or Scout Troop, 4-H, etc.)

Street Address

Address Line 2

City

State

Zip

Judging Category

K-2nd

3rd -5th

6th – 8th

9th – 12th

FOR LOCAL SECTION USE ONLY

Local Section Name (Number)

NCW Coordinator Name

Telephone

Email