2020 CCEW Illustrated Poem Contest
Protecting Our Planet through Chemistry
ENTRY FORM

Please fill out this form and email a scanned copy of your poem here from one of the email addresses include in the form below. All fields are required. Incomplete forms will invalidate the entry.

The deadline for the New Haven Local Section Contest is 04/25/20.

Student Name

First Name

Last Name

Student Grade

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Email

Parent/Guardian Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

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

Teacher Name

First Name

Last Name

Teacher Email

School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please send any follow up for the student to the:

Parent Address

School Address

Illustration Type

Hand-drawn art

Digitally created art

If the poem was digitally created, please name the software used in the box below

Judging Category by Grade

K-2

3-5

6-8

9-12

PoetryContest2020

2020 CCEW Illustrated Poem Contest
Protecting Our Planet through Chemistry
ENTRY FORM

Please fill out this form and email a scanned copy of your poem here from one of the email addresses include in the form below. All fields are required. Incomplete forms will invalidate the entry.

ACS New Haven Local Section

ACS | NH Local Section

PoetryContest2020

2020 CCEW Illustrated Poem ContestProtecting Our Planet through Chemistry ENTRY FORM

Please fill out this form and email a scanned copy of your poem here from one of the email addresses include in the form below. All fields are required. Incomplete forms will invalidate the entry.

ACS New Haven Local Section

2020 CCEW Illustrated Poem Contest
Protecting Our Planet through Chemistry
ENTRY FORM