8/2/2019 Google Doodle No Logo
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page 1 of 2
TO ENTER:
1. An eligible entry consists of:
a) Page 1 of this form completed and signed by the student's
parent/guardian.b) The artwork submission completed on page 2 of
this form. Both pages must be submitted together.
2. For legibility purposes, we encourage you to complete the
form on your computer as the fields are editable.3. Once complete,
please print out the form on a light colored 8.5"x11" sheet of
paper. Be sure to print on 2 separate pages.4. Make sure the
student's parent or guardian has signed the form on the appropriate
line. The entry will not be considered
without this signature.5. Mail your form to the address below.
Note all entries must be mailed by March 20, 2012 so please allow
enough time.
STUDENTS NAME
STUDENTS AGE
PARENT/GUARDIANS NAME
ADDRESS
CITY STATE ZIP
PARENT/GUARDIANS PHONE NUMBER
EMAIL ADDRESS
SCHOOL NAME
TO BE COMPLETED BY PARENT/LEGAL GUARDIAN OF STUDENT ENTERING THE
CONTEST.
All fields are required.SUPPORTING STATEMENT:
Please tell us briefly how your doodle expresses the themeIf I
could travel in time, Id visit... (max 50 words):
GENDER: MALE FEMALE
OFFICIAL
ENTRY FORM
Entries received without this COMPLETED Entry Form will not
be
accepted or judged and will be disqualified. Entries must be
mailed by March 20, 2012 in order to be considered.
PARENT/GUARDIANS
FULL-TIME
Alyssa Michelle Heidorn
14
John & Irene Heidorn
4050 Laurel Flat Court
Las Vegas N V 89129
702 496 3639
[email protected]
West Career and Technical Academy
It shows the prehistoric times, and that's where I'dvisit if I
could travel in time.
