The theme for the 2019 year is, ‘Look Within’.
| Entry Form |
STUDENT NAME _______________________________ GRADE ______ AGE ______ CLASSROOM __________
PARENT/GUARDIAN NAME ______________________ EMAIL ________________ PHONE ________________
MAILING ADDRESS _____________________________ CITY ______________ STATE _________ ZIP _______
Ownership in any submission shall remain the property of the entrant, but entry into this program constitutes entrant’s irrevocable permission and consent that PTA may display, copy, reproduce, enhance, print, sublicense, publish, distribute and create derivative works for PTA purposes. PTA is not responsible for lost or damaged entries. Submission of entry into the PTA Reflections program constitutes acceptance of all rules and conditions. I agree to the above statement and the National PTA Reflections Official Rules.
STUDENT SIGNATURE _______________________ PARENT/GUARDIAN SIGNATURE ____________________
GRADE DIVISION (Check One) ARTS CATEGORY (Check One)
¨ PRIMARY (Pre-K-Grade 2) ¨ DANCE CHOREOGRAPHY
¨ INTERMEDIATE (Grades (3-5) ¨ FILM PRODUCTION
¨ MIDDLE SCHOOL (Grades 6-8) ¨ LITERATURE
¨ HIGH SCHOOL (Grades 9-12) ¨ MUSIC COMPOSITION
¨ SPECIAL ARTIST (All Grades) ¨ PHOTOGRAPHY
¨ VISUAL ARTS
TITLE OF WORK ____________________________________________ DETAILS _________________________
If background music is used in dance/film, citation is required. Include word count for literature. List musician(s) or instrumentation for music. List dimensions for photography/visual arts.
ARTIST STATEMENT (In 10 to 100 words, describe your work and how it relates to the theme)
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Deadline is December 6, 2019
