Art Competition

Please fill out and submit the form below in order to register for the Congressional Art Competition.

* marks required fields of data.

Student Information

Prefix:

First Name: *

Middle Initial:

Last Name: *

Suffix:

Grade: *

T-Shirt Size: *

Student Contact Information

Street Address: *

Street Address Continued:

City: *

State: *

Zip Code: *

Student Phone Number *

Parent Information

Parents/Guardians Name(s): *

Parent Home Phone Number: *

Parent Work/Cell Phone Number: *

School Information

Name of High School: *

Street Address: *

City: *

State: *

Zip Code: *

Art Teacher Name: *

Art Teacher Phone Number: *

Art Teacher Email: *

Entry Information

Entry Title: *

Medium: *

Description: *

Photo *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

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